The patient is malnourished and has a low serum albumin. The ...

[james]

The patient is malnourished and has a low serum albumin. The physician has ordered aspirin, a highly protein-bound drug, for the patient. Which evaluation by the nurse best describes the effect this will have on the patient?
 
  1. The patient will be at risk to experience a decreased effectiveness of the drug.
  2. The patient will be at risk to experience toxic effects of the drug.
  3. The patient's kidneys will excrete the drug at a faster rate.
  4. The patient's serum globulin is more important than serum albumin.

Question 2

The patient has meningitis. The physician initially prescribed a water-soluble drug. Another physician changed the order to a lipid-soluble drug. The patient is confused about this. Which plan best resolves the patient's concern?
 
  1. Teach the patient that lipid-soluble drugs are better because of protein binding.
  2. Teach the patient that lipid-soluble drugs are more effective in treating his illness.
  3. Teach the patient that lipid-soluble drugs are better because they have fewer side effects.
  4. Teach the patient that lipid-soluble drugs are more effective because they are excreted at a slower rate.

[manuelcastillo]

Answer to Question 1

Correct Answer: 2
Rationale: Aspirin is a protein-bound drug. With a low albumin, there is less protein for aspirin to bind with, making more free drug available. There may be toxic, not decreased, effects from the drug because there is less protein for aspirin to bind with and more free drug available. The kidney will not be able to balance the amount of the drug and excrete it at a faster rate. Serum albumin plays a major role, more than serum globulin.

Answer to Question 2

Correct Answer: 2
Rationale: Drug molecules that are lipid soluble will usually pass through plasma membranes by simple diffusion and more easily reach their target cells. Lipid-soluble drugs do not necessarily have fewer side effects. Not all lipid-soluble drugs are protein bound. Lipid solubility does not affect drug excretion.

[james]

Thank you!

[manuelcastillo]

Always glad to help...