A 9-week-old infant is scheduled for a cleft lip repair. What information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?
Urine specific gravity is 1.011
White blood cell count of 10,000/mm³
Weight gain of 2 pounds (0.91 kg) since birth
Red blood cell count of 2.3 x 10²/L
The Correct Answer is D
Answer is... Choice D. Red blood cell count of 2.3 x 10²/L.
Choice A rationale:
In considering the 9-week-old infant scheduled for a cleft lip repair, it's crucial to evaluate various physiological parameters to ensure optimal surgical outcomes. The urine specific gravity of 1.011 falls within the normal range for infants, typically ranging from 1.001 to 1.020. This parameter primarily reflects the concentration of solutes in the urine and is influenced by hydration status. While deviations from the normal range may indicate certain renal conditions or hydration imbalances, a value of 1.011 alone does not signify a critical concern warranting immediate attention before surgery.
Choice B rationale:
A white blood cell count of 10,000/mm³ suggests a normal leukocyte count within the expected range for infants. The normal range for white blood cell count in infants is approximately 6,000 to 17,000/mm³. This parameter serves as an indicator of the body's immune response and can elevate in response to infection or inflammation. However, in the absence of clinical signs or symptoms suggestive of infection, such as fever or localized inflammation at the surgical site, a white blood cell count of 10,000/mm³ is not indicative of an urgent issue necessitating immediate communication with the surgeon.
Choice C rationale:
Weight gain of 2 pounds (0.91 kg) since birth is a positive indicator of growth and development in the infant. Infants typically exhibit rapid weight gain during the first few months of life, with an average weight gain of approximately 0.5 to 1 ounce per day or 1 to 2 pounds per month. This signifies adequate nutritional intake and physiological growth, which are essential for surgical readiness and postoperative recovery. However, while weight gain is an important parameter to monitor in pediatric patients, it does not directly impact the immediate preoperative considerations for a cleft lip repair.
Choice D rationale:
The red blood cell count of 2.3 x 10²/L is the most critical parameter requiring communication with the surgeon before transporting the infant to the surgical suite. A red blood cell count below the normal range can indicate anemia, which may pose risks during surgery, including impaired oxygen delivery to tissues and compromised hemostasis. Normal red blood cell counts in infants typically range from 3.9 to 5.2 x 10^12/L. Anemia in pediatric patients can result from various etiologies, including nutritional deficiencies, hemolytic disorders, or bone marrow suppression. Communicating a low red blood cell count ensures that the surgical team is aware of this potential risk factor and can take appropriate measures, such as transfusion or adjustments to the surgical plan, to mitigate perioperative complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Sodium levels are not typically affected by hypoparathyroidism. Hypoparathyroidism primarily affects calcium and phosphorus levels in the body.
Choice B rationale
Hypoparathyroidism leads to abnormally low levels of parathyroid hormone, which results in low calcium levels in the blood. A carpal spasm when pressure is applied to the upper arm, also known as Trousseau’s sign, is a common symptom of hypocalcemia.
Choice C rationale
Potassium levels are not typically affected by hypoparathyroidism. Hypoparathyroidism primarily affects calcium and phosphorus levels in the body.
Choice D rationale
Chloride levels are not typically affected by hypoparathyroidism. Hypoparathyroidism primarily affects calcium and phosphorus levels in the body.
Correct Answer is A
Explanation
Choice A rationale
The startle reflex, also known as the Moro reflex, is a normal response in newborns but typically disappears around 4 to 6 months of age. If a 6-month-old infant still demonstrates this reflex, it may indicate neurological issues that require further evaluation.
Choice B rationale
Playing “peek-a-boo” is a normal developmental milestone for a 6-month-old infant. It shows that the infant is starting to understand object permanence, which is the understanding that objects continue to exist even when they cannot be seen.
Choice C rationale
Doubling birth weight by 6 months is a normal growth milestone for infants. This indicates that the infant is growing and developing as expected.
Choice D rationale
Turning the head to locate sound is a normal developmental milestone for a 6-month-old infant. This shows that the infant’s hearing and neck muscles are developing appropriately.
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