A nurse is caring for a client who has undergone hemodialysis.
Which of the following findings should the nurse report to the provider?

C. Unable to remember their adult children's names.

D. Unable to answer a judgment task correctly.

Answer and explanation

The correct answer is Choice A.

Choice A rationale

Inability to remain fully awake after head trauma indicates decreased neurological function, a sign of intracranial injury or bleeding, requiring immediate attention. Reduced consciousness compromises airway protection and perfusion. Normal intracranial pressure ranges from 7 to 15 mmHg in adults; elevated levels can indicate pathology. This finding is critical for prioritization to prevent irreversible brain damage.

Choice B rationale

Difficulty repeating named objects suggests short-term memory loss, often linked to conditions like concussion. However, it does not pose an immediate life threat like compromised consciousness does. Neurological evaluation is necessary but secondary in priority unless paired with other severe symptoms like loss of consciousness or seizures.

Choice C rationale

Failure to recall adult children’s names suggests long-term memory impairment. While it may indicate brain injury or dementia exacerbation, it is not an immediate threat compared to decreased alertness. Cognitive decline should be addressed later after stabilizing potential life-threatening conditions.

Choice D rationale

Errors in judgment tasks reflect possible frontal lobe dysfunction or cognitive impairment. Though concerning, this is not the most urgent finding unless associated with symptoms like increased intracranial pressure or stroke. Addressing primary life-sustaining functions remains the priority.

Choice A rationale

Echinacea has immunomodulatory effects, potentially boosting immunity. While it interacts with some medications, its usage does not pose significant risks with anticoagulants like enoxaparin unless combined with other supplements or medications causing immune changes.

Choice B rationale

Ginkgo biloba increases the risk of bleeding due to its antiplatelet effects, which can compound the anticoagulant effects of enoxaparin. This interaction requires reporting to the provider to adjust or monitor anticoagulant therapy accordingly.

Choice C rationale

Probiotics support gut health but do not interact significantly with anticoagulants or alter coagulation parameters. Their usage can generally be continued unless specific contraindications arise with concurrent conditions or medications.

Choice D rationale

Flaxseed powder is a source of omega-3 fatty acids, which may have mild anticoagulant effects. However, this interaction is not typically strong enough to warrant reporting unless combined with other supplements affecting coagulation.