The primary care NP administers penicillin G (Bicillin) to a 75-year-old patient who has COPD and heart failure. The patient takes digoxin, warfarin, and spironolactone. To help prevent drug interactions, the NP should order:
a. serum electrolytes.
b. coagulation studies.
c. creatinine clearance.
d. liver transaminases aspartate aminotransferase and alanine aminotransferase.
A
Penicillin G can cause hyperkalemia, which can increase digoxin toxicity, so serum electrolytes should be monitored. Penicillin G does not interact with warfarin or spironolactone. Coagulation studies, creatinine clearance, and LFTs are not indicated in this circumstance.
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