1. Diltizaem- Calcium channel blocker- check HR before taking the medication

Diltiazem, a calcium channel blocker, has cardio-suppressant effects at the SA and AV

nodes, which can lead to bradycardia. The client should check their heart rate before

taking the medication and notify the provider if it falls below the expected reference

range. Vasodialator that causes orthostatic hypotension.

2. Atorvostatin for hyperlipidemia- the nurse should monitor creatinine kinase.

The client who is taking atorvastatin can develop an adverse effect called

rhabdomyolysis, which causes muscle weakness or pain and can progress to myositis.

Creatinine kinase levels rise in response to enzymes released with muscle injury.

Erythrocyte sedimentation rates (ESR) evaluate the speed at which red blood cells settle

in plasma over a set amount of time. The nurse should monitor ESR for clients who have

multiple myeloma, rheumatoid arthritis, and systemic lupus erythematosus. However,

ESR is not affected by statins, such as atorvastatin.

The international normalized ratio (INR) measures clotting abilities of the blood. The

nurse should monitor INR for clients who are receiving warfarin therapy.

Potassium is a major electrolyte that maintains acid-base balance, oncotic pressure, and

cardiac rhythm. The nurse should monitor potassium levels in clients who are receiving

loop diuretics, such as bumetanide.

3. Clozapine for schizophrenia- what lab tests should the nurse review before administering

med? Cholesterol-The nurse should review the client's total cholesterol before

administering clozapine, because this medication can cause hyperlipidemia.

The nurse should review the thyroid stimulating hormone level of a client who has

hypothyroidism or hyperthyroidism.

4. Flueoxetine for depression- May get headaches so take ibuprofen for HA’s.

Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when

used concurrently with NSAIDs and anticoagulants. Therefore, clients who are taking

fluoxetine should take acetaminophen for headaches or pain, since acetaminophen does

not suppress platelet aggregation.

The nurse should inform the client that the therapeutic levels of fluoxetine can take

between 1 and 4 weeks to achieve desired effects. The client should take the medication

as prescribed and use other strategies to manage depression in the interim

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