A client who takes furosemide (Lasix) and propranolol (Inderal) is scheduled for breast reconstruction surgery. Which additional client information requires prompt collaboration with the healthcare provider before surgery?
Serum potassium 3.2 mEq/L
Pulse rate 65 bpm
Hematocrit 36%
Blood pressure 144/82 mmHg
The Correct Answer is A
A. Serum potassium 3.2 mEq/L: A serum potassium level of 3.2 mEq/L is below the normal range (3.5-5.0 mEq/L) and indicates hypokalemia, which can cause serious cardiac arrhythmias and muscle weakness. This condition requires prompt correction and collaboration with the healthcare provider before surgery to avoid intraoperative and postoperative complications.
B. Pulse rate 65 bpm: A pulse rate of 65 bpm is within the normal range (60-100 bpm). While it should be monitored, it does not require immediate intervention or collaboration with the healthcare provider before surgery.
C. Hematocrit 36%: A hematocrit level of 36% is within the lower end of the normal range (35-45% for women). This does not indicate an immediate concern that requires prompt collaboration with the healthcare provider.
D. Blood pressure 144/82 mmHg: Although this blood pressure reading is slightly elevated, it is not uncommon and can be managed perioperatively. It does not require immediate intervention before surgery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Kayexalate (sodium polystyrene): This is the correct choice. Kayexalate is used to treat hyperkalemia (high serum potassium levels) by facilitating the removal of excess potassium from the body through the gastrointestinal tract.
B. Potassium chloride: This is used to treat hypokalemia (low potassium levels), not hyperkalemia.
C. Sodium bicarbonate: This can be used to correct metabolic acidosis and may indirectly help with potassium levels, but it is not the primary treatment for hyperkalemia.
D. Aldactone (spironolactone): This is a potassium-sparing diuretic that can increase potassium levels, which would be contraindicated in the case of hyperkalemia.
Correct Answer is B
Explanation
A. Start an IV of DSNS with 40 mEq KCI at 125 mL/hr: Starting an IV is important but may not be the immediate first step. The client's symptoms suggest hypotension, likely due to hypovolemia, which needs immediate positional intervention before fluid administration.
B. Elevate the feet and lower the head: This position, known as the Trendelenburg position, helps increase venous return to the heart and can quickly improve blood pressure and perfusion to vital organs. It is an immediate intervention for hypotension.
C. Call the surgeon and report the vital signs: While important, calling the surgeon is not the first intervention. Immediate action to stabilize the client's condition is necessary before notifying the healthcare provider.
D. Monitor the vital signs every 15 minutes: Monitoring is important, but it is not an immediate intervention. The nurse must first address the client's low blood pressure and symptoms of hypoperfusion before continuing regular monitoring.
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