A nurse is assisting with the admission of a client who has hyperemesis gravidarum. Which of the following laboratory tests is the priority to complete?
Serum bilirubin
Liver enzymes
Urinalysis for ketones
CBC
The Correct Answer is C
(a) Serum bilirubin:
While serum bilirubin can provide useful information about liver function, it is not the most immediate concern for a client with hyperemesis gravidarum. This condition primarily involves severe nausea and vomiting, which can lead to dehydration and ketosis.
(b) Liver enzymes:
Liver enzymes can be elevated in hyperemesis gravidarum, but they are not the primary concern. The immediate priority is to assess the extent of dehydration and metabolic disturbances.
(c) Urinalysis for ketones:
This test is the priority because it helps determine the extent of dehydration and ketosis. In hyperemesis gravidarum, severe vomiting can lead to significant fluid and electrolyte imbalances and ketosis, which need to be identified and corrected promptly to prevent further complications.
(d) CBC:
A complete blood count (CBC) provides useful information about overall health and can identify anemia or infection, but it is not the priority for immediate assessment of hyperemesis gravidarum. The immediate need is to evaluate hydration status and ketosis, which is best done through urinalysis for ketones.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
(a) "White blood cell count is an indicator of anemia."
A white blood cell (WBC) count is primarily used to assess for infection or inflammation, not anemia. Anemia is typically evaluated by measuring hemoglobin and hematocrit levels, not WBC count. This statement indicates a misunderstanding of the purpose of the WBC count.
(b) "Urine specific gravity identifies my risk for pregnancy induced hypertension."
Urine specific gravity measures the concentration of urine and is used to assess hydration status and kidney function. It does not directly identify the risk for pregnancy-induced hypertension (PIH). The presence of protein in the urine (proteinuria) would be more indicative of PIH. This statement indicates a misunderstanding of the purpose of the urine specific gravity test.
(c) "Platelet count identifies if I am at risk for bleeding."
This is the correct statement. A platelet count is used to determine the number of platelets in the blood, which are essential for normal blood clotting. A low platelet count (thrombocytopenia) can indicate an increased risk of bleeding, while a high count (thrombocytosis) can be associated with clotting disorders.
(d) "Sedimentation rate checks for signs of cancer."
The erythrocyte sedimentation rate (ESR) measures how quickly red blood cells settle at the bottom of a test tube. It is a nonspecific test used to detect inflammation in the body. While an elevated ESR can be associated with various conditions, including infections, autoimmune diseases, and cancers, it is not specifically used to check for cancer. This statement indicates a misunderstanding of the purpose of the sedimentation rate test.
Correct Answer is D
Explanation
(A) Ask a parent to state the newborn's date of birth:
While asking a parent to state the newborn's date of birth may seem like a reasonable step, it relies on the parent's memory and verbal confirmation, which may not always be accurate. It's possible for a parent to forget or provide incorrect information, leading to potential identification errors.
(B) Check the newborn's footprint sheet with the medical record:
Footprint identification is a common practice in hospitals, but it may not always be feasible or practical during routine newborn transport to parents. Additionally, relying solely on footprints for identification may not be as reliable as comparing identification bands, as footprints can smudge or be difficult to match accurately.
(C) Request a parent to verify the newborn's name:
Asking a parent to verify the newborn's name relies on verbal confirmation, similar to option A. While it may provide some level of reassurance, it is not as reliable as comparing identification bands to confirm identity. Additionally, newborns may not yet have been formally named at the time of transport.
(D) Compare numbers on the newborn's band to the parent's band:
Comparing the identification numbers on the newborn's identification band with those on the parent's identification band is the most reliable method to confirm the newborn's identity. This process ensures that the newborn is matched with the correct parent(s) before handing over the infant. It helps prevent instances of newborn mix-up or abduction.
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