Certified Medical-Surgical Registered Nurse Practice Exam

For a patient taking Glucophage, what is crucial for the nurse to monitor upon discharge?

1. Glomerular filtration rate.

2. Serum amylase.

3. Red blood cell count.

4. Urine for casts.

The correct answer is: Glomerular filtration rate.

Monitoring the glomerular filtration rate (GFR) for a patient taking Glucophage, which is the brand name for metformin, is crucial due to the medication's potential impact on renal function. Metformin is primarily eliminated by the kidneys, and impaired renal function can lead to accumulation of the drug, increasing the risk of lactic acidosis, a serious and potentially life-threatening condition. Patients with elevated creatinine levels or a GFR below a certain threshold (generally 30 mL/min) are at increased risk for adverse effects when using metformin. Therefore, ensuring that the patient's renal function is stable and within acceptable limits before discharge helps to minimize complications and promotes safe medication administration. The other options do not carry the same level of immediate importance regarding the management of a patient on metformin. Serum amylase is primarily relevant for pancreatitis or pancreatic disorders, the red blood cell count is more related to hematologic conditions, and urine for casts is utilized in assessing kidney pathology. While these are important in their contexts, they do not directly address the significant risks associated with metformin usage like monitoring renal function does.