A client is post-op nephrectomy for renal cancer. Which lab results would cause most concern for the nurse?

Table 34.1 Review of Normal Ranges for Complete Blood Cell Counts (Adult)

Blood Cell

Normal Ranges

Red blood cells (mature, circulating)

Male 4.51-6.01 million/mm3

Female: 4.01-5.51 million/mm3

Hemoglobin

Adult (15-64 yr)

Male 14-17.3 g/dL

Female 11.7-15.5 g/dL

Hematocrit

42% -52% in males

36% -48% in females

Reticulocytes

0.5% -2.5% of total RBC count

White blood cells (total)

4.5-11.1 103/mm3

Neutrophils

59%

Bands 3%

Segs-56%

Eosinophils

2.7%

Basophils

0.5%

Lymphocytes

34%

Monocytes

4%

Platelets

150,000-450,000/mm3

Hemoglobin of 14 g/dL

Platelet count 150,000 mm3

White blood cell count 17,000 mm3

Neutrophils 59%

Answer and Explanation

The Correct Answer is C

A.   This value is within the normal range for adult males (14-17.3 g/dL) and borderline for females (11.7- 15.5 g/dL). While the specific context of the patient (e.g., gender) matters, generally, a hemoglobin level of 14 g/dL would not typically cause concern.

B.   A platelet count of 150,000/mm³ is at the lower limit of normal (150,000-450,000/mm³). While this may be concerning in certain clinical contexts, it is still within the acceptable range and would not typically raise alarm for a post-op nephrectomy patient unless there are other indications of bleeding or clotting issues.
C.   This white blood cell count is elevated (normal range is 4.5-11.1 x 10³/mm³). An elevated WBC count can indicate an infection, inflammation, or a response to surgery, which is particularly concerning post- operatively. This result would warrant further investigation to rule out infection, which is critical for recovery.
D.   The neutrophil percentage of 59% is within the normal range (typically around 40-70% for total WBCs). While it is slightly elevated, it is not concerning on its own without additional context, especially since it may be elevated in response to surgery or stress.

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Correct Answer is A

Explanation

A. This is a valid consideration. Patients receiving radioactive iodine may emit radiation, so placing them in a private room can help minimize exposure to family members and staff. Isolation may be more strictly enforced based on the dose administered and hospital protocols.
B. This is generally not required for radioactive iodine treatment. Patients are often advised to have a low-iodine diet in the weeks leading up to treatment, but complete fasting for 24 hours prior is not standard practice. Clear instructions from the healthcare provider should be followed regarding diet.
C. This is typically not a requirement. While some patients may be advised to avoid strenuous activities immediately after treatment, there is no strict guideline stating that all physical activity must be avoided for 72 hours. Patients are usually encouraged to follow normal activities while being mindful of minimizing close contact with others.
D. This statement is generally incorrect. While certain medications may need to be adjusted or stopped before radioactive iodine treatment (for instance, thyroid medications), it’s not a blanket recommendation to stop all medications for a week. Patients should consult with their healthcare provider for personalized advice regarding their specific medications.

A. Petechiae and epistaxis B. Generalized edema and rash C. Alopecia and pallor D. Bradycardia and lethargy

Correct Answer is A

Explanation

A. Petechiae (small red or purple spots caused by bleeding under the skin) and epistaxis (nosebleeds) result from thrombocytopenia, which is a low platelet count often seen in leukemia. The compromised bone marrow function leads to inadequate production of platelets, resulting in bleeding and bruising.
B. While generalized edema and rash can occur in various conditions, they are not specific to ALL and are not common initial findings. Edema might be seen in certain contexts (e.g., renal involvement or fluid overload), but it is not a hallmark of ALL.
C. Alopecia (hair loss) and pallor (paleness) can occur in clients undergoing chemotherapy for ALL, but they are not typically initial findings at the time of diagnosis. Pallor may result from anemia, which can develop as a consequence of the disease, but it is not the most immediate or characteristic symptom of ALL.
D. Bradycardia (slow heart rate) and lethargy are not typical initial findings of ALL. Lethargy could be present due to anemia or other systemic effects, but bradycardia is not commonly associated with the disease and would require further investigation for other underlying causes.

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Blood Cell	Normal Ranges
Red blood cells (mature, circulating)	Male 4.51-6.01 million/mm3 Female: 4.01-5.51 million/mm3
Hemoglobin	Adult (15-64 yr) Male 14-17.3 g/dL Female 11.7-15.5 g/dL
Hematocrit	42% -52% in males 36% -48% in females
Reticulocytes	0.5% -2.5% of total RBC count
White blood cells (total)	4.5-11.1 103/mm3
Neutrophils	59% Bands 3% Segs-56%
Eosinophils	2.7%
Basophils	0.5%
Lymphocytes	34%
Monocytes	4%
Platelets	150,000-450,000/mm3

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Naxlex Comprehensive Predictor Exams

The nurse should implement which safety considerations for a patient when administering oral iodine radioactive for thyroid cancer?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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