Author Question: The nurse in a pulmonary clinic is evaluating several clients' theophylline levels. Which levels ... (Read 59 times)

jasdeep_brar · **on:** Jul 23, 2018

The nurse in a pulmonary clinic is evaluating several clients' theophylline levels. Which levels would take the highest priority?

Standard Text: Select all that apply.
1. 8 mcg/mL
2. 19 mcg/mL
3. 21 mcg/mL
4. 12 mcg/mL
5. 15 mcg/mL

Question 2

The nurse is reviewing the admission history of a client taking zileuton (Zyflo CR) in the emergency department. Which patient reports would take highest priority during the physical assessment?

Standard Text: Select all that apply.
1. Sinusitis
2. Nausea
3. Yellow skin
4. Abdominal pain
5. Throat pain

SamMuagrove · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1,2,3
Rationale 1: This theophylline level is below therapeutic range.
Rationale 2: This theophylline level is nearing toxic levels.
Rationale 3: This theophylline level is in the toxic range.
Rationale 4: This theophylline level is in the therapeutic range.
Rationale 5: This theophylline level is in the therapeutic range.
Global Rationale: Theophylline has a very narrow therapeutic index. Therapeutic levels are 10 to 15 mcg/mL and the toxic level is anything above 20 mcg/mL.

Answer to Question 2

Correct Answer: 2,3,4
Rationale 1: Sinusitis is an adverse effect but would not be a priority complaint.
Rationale 2: Nausea can be a symptom of liver damage, which is a serious concern in clients taking zileuton.
Rationale 3: Yellow skin implies jaundice, which is a serious concern in clients taking zileuton.
Rationale 4: Abdominal pain can be a symptom of liver damage, which is a serious concern in clients taking zileuton.
Rationale 5: Throat pain is an adverse effect but would not be a priority complaint.
Global Rationale: Zileuton raises liver enzymes (alanine aminotransferase), and cases of jaundice and severe hepatic injury have been reported. Sinusitis and throat pain may occur, but are not priority issues.