Duloxetine (Cymbalta) is being considered in the treatment of a patient's depression. Which of the following laboratory values would prevent the patient from being treated with this medication?
A) Decreased hemoglobin level
B) Decreased potassium level
C) Increased ALT
D) Increased erythrocyte sedimentation rate
C
Feedback:
Duloxetine (Cymbalta) is highly protein bound, extensively metabolized by CYP2D6 and CYP1A2 enzymes in the liver, and excreted by the kidneys. It is not recommended for use in patients with severe renal or any degree of liver impairment. Low hemoglobin, elevated potassium, and increased ESR do not necessarily preclude the use of Cymbalta.
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The nurse educator is presenting information about the APIE method of charting as it will be implemented by the facility in a few weeks. Which statements by the participants indicate an appropriate understanding of this method of charting?
Select all that apply. 1. "I will only need to chart by exception with this method." 2. "Only subjective data are included in the assessment portion." 3. "The 'P' refers to the chief problem of the client." 4. "The activities implemented to manage the client's needs will be documented in the 'I' section." 5. "The 'E' refers to the evaluation that occurs after an intervention is implemented."
In evaluating the patient's hyponatremia, the nurse understands the problem is
a. increased cortisol release. c. increased glucocorticoid release. b. decreased aldosterone release. d. decreased glucagon release.
A mother explained that she had just dropped her 3-year-old off at her own mother's so she could come in for the required examination for her new job. She excitedly shared her hopes that she would be able to afford a used car rather than having to ride a
Which of the following would be the most appropriate response by the nurse? a. "I'm sure the exam won't show any problems. I'm so excited for you." b. "Don't forget to buy a child's seat when you get your car." c. "How do you think your child will adapt to you being at work all day?" d. "It's fantastic that you have a new job in this rough economy. Will your mother be able to continue to babysit?"
The nursing instructor is discussing chronic conditions and their effects on the body with her medical-surgical class. What would the nursing instructor explain to her students that a patient with diabetes is at risk for?
A) Arthritis B) Renal failure C) Cancer D) Asthma