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The practical nurse (PN) reviews the laboratory results of an elderly female client who is one day postoperative for a right total hip replacement (THR).

Which serum value result has the greatest implication for client safety?

Reference ranges

  • Hemoglobin (Hgb) [12 to 16 g/dL (120 to 160 g/L)]
  • Potassium (K+) [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
  • Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]
  • Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

A.

Sodium 130 mEq/L.

B.

Hemoglobin 8.9 grams/dL.

C.

Potassium 3.4 mEq/L

D.

Blood urea nitrogen 20 mg/dL.

Answer and Explanation

The Correct Answer is B

A.    Sodium level of 130 mEq/L is slightly below the lower limit of the reference range but might not have as immediate an impact on safety as a critically low hemoglobin level. 
B.    Hemoglobin of 8.9 grams/dL is significantly below the normal range and indicates a substantial drop in red blood cells, which can lead to impaired oxygen transport and potentially severe postoperative complications like inadequate tissue perfusion and oxygenation. 
C.    Potassium level of 3.4 mEq/L is slightly below the lower limit of the reference range but might not pose an immediate threat compared to a critically low hemoglobin level. 
D.    Blood urea nitrogen (BUN) of 20 mg/dL is at the upper limit of the reference range but might not have an immediate implication for client safety compared to a critically low hemoglobin level. 
 


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Related Questions

Correct Answer is B

Explanation

A. Urinary frequency. - Urinary frequency is not a typical symptom indicative of hypoglycemia.
B. Tachycardia. - Tachycardia, an increased heart rate, can be a sign of hypoglycemia as the body responds to low blood sugar by increasing the heart rate to compensate.
C. Elevated temperature. - Elevated temperature is not typically associated with hypoglycemia; it might suggest an infection or other issues.
D. Hypertension. - Hypertension, or high blood pressure, is not a typical sign of hypoglycemia; it might indicate other health conditions or issues.

Correct Answer is C

Explanation

A. Checking for kinks in the drainage tubing might be a part of troubleshooting, but the observed clots and thick red fluid require immediate attention, so informing the charge nurse is the priority.
B. Delaying assessment for another hour could potentially exacerbate the issue if there's a problem with the irrigation or if the client's condition worsens.
C. Reporting the finding to the charge nurse is crucial as it indicates potential complications such as bleeding or clot formation that need immediate intervention.
D. Immediately stopping the irrigation solution without proper assessment and guidance could lead to complications and isn't the initial action warranted in this situation.

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