Question

The client is being treated with acarbose (Precose). Which laboratory results should be reported to the physician? A. White blood cell count of 5,000 B. Blood urea nitrogen level of \(26 \mathrm{mg} / \mathrm{dL}\) C. Creatinine level of \(0.8 \mathrm{mg} / \mathrm{dL}\) D. Platelet count of 200,000

Short answer

Answer: B. Blood urea nitrogen level of \(26 \mathrm{mg} / \mathrm{dL}\)

Step-by-step solution

Understand Acarbose Therapy

Acarbose (Precose) is an oral medication used to treat type 2 diabetes. It works by inhibiting the breakdown of complex carbohydrates, thereby slowing the absorption of glucose and preventing a postprandial spike in blood sugar levels. Some potential side effects of acarbose include gastrointestinal symptoms like flatulence, diarrhea, and abdominal discomfort. Liver dysfunction and renal impairment may also occur. Thus, laboratory tests related to kidney and liver function should be closely monitored.

Evaluate the Choices

A. White blood cell (WBC) count of 5,000: This lab result represents a normal WBC count and does not indicate any issue related to acarbose treatment. It is not necessary to report this result. B. Blood urea nitrogen (BUN) level of \(26 \mathrm{mg} / \mathrm{dL}\): The normal range for BUN levels is \(8-20 \mathrm{mg} / \mathrm{dL}\). A BUN level of 26 indicates that it is elevated, which could indicate kidney issues. This result should be reported to the physician since acarbose therapy may cause renal impairment. C. Creatinine level of \(0.8 \mathrm{mg} / \mathrm{dL}\): This lab result represents a normal creatinine level, which is an indicator of good kidney function. It does not indicate any issue related to acarbose treatment. It is not necessary to report this result. D. Platelet count of 200,000: A normal platelet count ranges between 150,000 and 450,000. This lab result is within the normal range, and it does not indicate any issue related to acarbose treatment. It is not necessary to report this result.

Choose the Correct Answer

Out of the given choices, the one that should be reported to the physician is B. Blood urea nitrogen level of \(26 \mathrm{mg} / \mathrm{dL}\), since it is elevated and could indicate potential kidney issues related to acarbose therapy.

Key concepts

Type 2 Diabetes Treatment

Type 2 diabetes is a chronic condition that affects the way the body processes blood sugar (glucose). Factors such as genetics, lifestyle, and being overweight can influence its development. Managing this condition involves a combination of diet, exercise, weight management, and medication.

One commonly prescribed medication is acarbose (Precose), which helps lower blood sugar by slowing the breakdown of starches in the diet. It's taken with the first bite of a meal to be most effective. Acarbose is part of an overall treatment plan which may include other oral medications or insulin therapy, depending on the individual's needs and the progression of the condition.

It's important to remember that while medications can assist in controlling glucose levels, lifestyle modifications such as reducing sugar intake, increasing physical activity, and adhering to a diabetic diet plan are crucial for managing type 2 diabetes effectively.

Laboratory Test Monitoring

When treating conditions like type 2 diabetes, regular monitoring through laboratory tests is crucial to ensure the safety and effectiveness of the treatment. Common tests include measurements of blood glucose, Hemoglobin A1c, kidney function tests (like BUN and creatinine), and liver function tests.

Kidney Function Tests

For those on acarbose therapy, monitoring kidney function is essential as this medication can potentially cause renal impairment. Blood urea nitrogen (BUN) and creatinine levels are often checked as indicators of kidney health. BUN levels above the normal range of 8-20 mg/dL can suggest that the kidneys are not working properly.

Liver Function Tests

Liver enzyme tests should also be performed since acarbose has been associated with liver dysfunction. Regular monitoring helps in detecting any abnormalities early, allowing for timely interventions. It is recommended to report any unusual laboratory results to a physician so that they can adjust the treatment plan if necessary.

Renal Impairment Detection

Detecting renal impairment early in patients with type 2 diabetes is vital to prevent further complications. Kidneys filter wastes from the blood and regulate other functions like electrolyte balance and blood pressure. Renal impairment implies that the kidneys are not functioning properly.

Diabetes is a risk factor for kidney disease due to the potential for high blood sugar levels to damage blood vessels in the kidneys over time. Tests like BUN and creatinine levels are used to monitor kidney function. Creatinine, a byproduct of muscle metabolism, is filtered by the kidneys. Consequently, high levels of creatinine or BUN could signal a decline in kidney function.

Patients on acarbose may have their kidney function tested regularly to catch any changes early. Any significant changes in the BUN or creatinine levels, such as the BUN level of 26 mg/dL noted in the exercise, should be promptly reported to a healthcare provider. Early detection allows for management modifications, potential medication adjustments, and other interventions to protect kidney health.