The nurse is caring for a patient in the hospital for pneumonia ...

[ts19998]

The nurse is caring for a patient in the hospital for pneumonia but also has a severe case of psoriasis that is being treated with methotrexate.
 
  During the morning assessments, which of the following lab values would alert the nurse that the patient may be experiencing a side effect to this medication? Select all that apply.
  A)
  Serum potassium (K+) level 3.6 mmol/L
  B)
  Platelet count 37  103/ L
  C)
  Alanine aminotransferase (ALT) 28 units/L
  D)
  White blood cell count 1.2  103/ L

Question 2

A 51-year-old woman who was born congenitally blind and deaf is able to distinguish individuals by light touch of the individual's face. Which of the following components of the woman's skin innervation likely contributes the most to this ability?
 
  A)
  Ruffini corpuscles
  B)
  Meissner corpuscles
  C)
  Pacinian corpuscles
  D)
  Nociceptors

[wtf444]

Answer to Question 1

Ans:
B, D

Feedback:

Methotrexate is an antimetabolite that inhibits DNA synthesis and prevents cell mitosis. Oral methotrexate has been effective in treating psoriasis when other approaches have failed. The side effects include nausea, leukopenia (low WBC count), thrombocytopenia (low platelet count), and liver function abnormalities. The low platelet count corresponds to thrombocytopenia, and the low WBC corresponds to leucopenia. The other lab values, K+ and ALT, are within the normal adult range.

Answer to Question 2

Ans:
B

Feedback:

Meissner corpuscles are rapidly adapting nerve endings located on the palmar surfaces of the fingers and hands; as such, they would be likely to be involved in fine distinction using the fingers. Ruffini corpuscles are located in the subcutaneous tissue of hairy and glabrous skin, while pacinian corpuscles detect gross pressure and vibration. Nociceptors detect painful stimuli.