The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?

Calcium 8.6 mg/dL

WBC 19,000 mm3

Serum pH 7.33

Hemoglobin 9 mg/dL

Answer and Explanation

The Correct Answer is B

Choice A rationale: A calcium level of 8.6 mg/dL is within the normal range.

Choice B rationale: An elevated white blood cell count (WBC) of 19,000 mm3 indicates a potential infection or inflammatory process, requiring immediate attention, especially in a client receiving peritoneal dialysis.

Choice C rationale: A serum pH of 7.33 is within the normal range.

Choice D rationale: A hemoglobin level of 9 mg/dL might indicate anemia, but in a client receiving dialysis, it might not require immediate reporting unless it significantly drops further.

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Correct Answer is A

Explanation

Choice A rationale: These lab findings, particularly concentrated urine (high specific gravity) and hyponatremia, are consistent with SIADH, where excessive ADH secretion leads to water retention and dilutional hyponatremia.

Choice B rationale: While it can affect sodium levels, Cushing's syndrome typically results in hypernatremia or normal sodium levels rather than hyponatremia.

Choice C rationale: Usually presents with hyponatremia but not specifically with high urine specific gravity or hematocrit.

Choice D rationale: DI is associated with high serum sodium and low urine specific gravity due to excessive excretion of dilute urine.

A. Anterior spinal artery syndrome B. Cauda equina syndrome C. Horner's syndrome D. Brown-Séquard syndrome

Correct Answer is B

Explanation

Choice A rationale: Anterior spinal artery syndrome is caused by ischemia of the anterior two-thirds of the spinal cord, resulting in loss of motor function and pain and temperature sensation below the level of the lesion.

Choice B rationale: This is a condition that occurs when the nerve roots in the lower end of the spinal cord are compressed, causing symptoms such as lower back pain, sciatica, saddle anesthesia, bladder and bowel dysfunction, and sexual dysfunction.

Choice C rationale: Horner's syndrome is caused by damage to the sympathetic nerve fibers in the neck or chest, resulting in drooping eyelid, constricted pupil, and lack of sweating on one side of the face.

Choice D rationale: Brown-Séquard syndrome is caused by hemisection of the spinal cord, resulting in ipsilateral loss of motor function and proprioception and contralateral loss of pain and temperature sensation below the level of the lesion.

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