The nurse in the medical-surgical unit is caring for a 61-year-old male client.
Day 2
0730:Admitted on Day 1 for evaluation of unintended weight loss. History of type 2 diabetes mellitus, treated with metformin at home. Metformin is prescribed twice daily in the hospital, and the 0800 dose is due. A computed tomography (CT) scan is ordered for today. The morning laboratory tests include an estimated glomerular filtration rate (eGFR).
Click to highlight the findings below that require follow-up before the nurse gives the 0800 dose of metformin.
| Assessment | Findings at 0730 |
|---|---|
| Vital signs | blood pressure 128/78; pulse 76; respirations 16 |
| Laboratory results | potassium 4.2 mEq/L (reference range 3.5–5.0 mEq/L); eGFR 26 mL/min/1.73 m² (reference range 90–120 mL/min/1.73 m²); hemoglobin A1C 7.6% (reference range below 5.7%) |
| Nutrition | nothing by mouth since midnight, as ordered; capillary glucose 96 mg/dL at 0700 (fasting reference range 70–99 mg/dL) |
| Scheduled today | CT of the abdomen with IV iodinated contrast at 1000 |
| History | no known allergies to medications, foods or contrast media; drinks 1 glass of wine with dinner on weekends |