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)]
Sodium 130 mEq/L.
Hemoglobin 8.9 grams/dL.
Potassium 3.4 mEq/L
Blood urea nitrogen 20 mg/dL.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Asking about the bowel sterilization prescription isn't directly related to the client's concern about the visibility of the surgical opening.
B. Reviewing the client's expectations regarding elimination after surgery helps address the client's concerns about the surgical opening and ensures proper education and understanding.
C. Verifying the NPO status is important for surgery preparation but doesn’t address the client's specific concern.
D. Understanding if this is the client's first indwelling catheter doesn’t directly address the immediate concern of the client regarding the visibility of the surgical opening.
Correct Answer is C
Explanation
A. Checking for kinks in the drainage tubing is important, but the observed clots and thick red fluid suggest potential complications that require immediate attention and should be reported. B. Waiting for an hour to observe again could delay necessary interventions if there's an issue with bleeding or clot formation, so reporting immediately is more prudent.
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. Stopping the irrigation solution without proper assessment and guidance could lead to complications and isn't the initial action warranted in this situation. Reporting to a superior nurse allows for prompt evaluation and intervention.
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