The nurse is caring for a child with hypoparathyroidism who exhibits a carpal spasm when pressure is applied to the upper arm. Which laboratory value should the nurse review?

Answer is... Choice D. Red blood cell count of 2.3 x 10²/L.

Choice A rationale:

In considering the 9-week-old infant scheduled for a cleft lip repair, it's crucial to evaluate various physiological parameters to ensure optimal surgical outcomes. The urine specific gravity of 1.011 falls within the normal range for infants, typically ranging from 1.001 to 1.020. This parameter primarily reflects the concentration of solutes in the urine and is influenced by hydration status. While deviations from the normal range may indicate certain renal conditions or hydration imbalances, a value of 1.011 alone does not signify a critical concern warranting immediate attention before surgery.

Choice B rationale:

A white blood cell count of 10,000/mm³ suggests a normal leukocyte count within the expected range for infants. The normal range for white blood cell count in infants is approximately 6,000 to 17,000/mm³. This parameter serves as an indicator of the body's immune response and can elevate in response to infection or inflammation. However, in the absence of clinical signs or symptoms suggestive of infection, such as fever or localized inflammation at the surgical site, a white blood cell count of 10,000/mm³ is not indicative of an urgent issue necessitating immediate communication with the surgeon.

Choice C rationale:

Weight gain of 2 pounds (0.91 kg) since birth is a positive indicator of growth and development in the infant. Infants typically exhibit rapid weight gain during the first few months of life, with an average weight gain of approximately 0.5 to 1 ounce per day or 1 to 2 pounds per month. This signifies adequate nutritional intake and physiological growth, which are essential for surgical readiness and postoperative recovery. However, while weight gain is an important parameter to monitor in pediatric patients, it does not directly impact the immediate preoperative considerations for a cleft lip repair.

Choice D rationale:

The red blood cell count of 2.3 x 10²/L is the most critical parameter requiring communication with the surgeon before transporting the infant to the surgical suite. A red blood cell count below the normal range can indicate anemia, which may pose risks during surgery, including impaired oxygen delivery to tissues and compromised hemostasis. Normal red blood cell counts in infants typically range from 3.9 to 5.2 x 10^12/L. Anemia in pediatric patients can result from various etiologies, including nutritional deficiencies, hemolytic disorders, or bone marrow suppression. Communicating a low red blood cell count ensures that the surgical team is aware of this potential risk factor and can take appropriate measures, such as transfusion or adjustments to the surgical plan, to mitigate perioperative complications.

Choice A rationale
Flexing the knees is not the recommended technique when moving a client who is recovering from surgical spinal instrumentation for scoliosis. While it may provide some comfort, it does not provide the necessary support to the spine that is needed during movement.
Choice B rationale
Raising the hips is not the recommended technique when moving a client who is recovering from surgical spinal instrumentation for scoliosis. This action could potentially cause strain or damage to the surgical site.
Choice C rationale
Crossing the arms and legs is not the recommended technique when moving a client who is recovering from surgical spinal instrumentation for scoliosis. This action does not provide the necessary support to the spine during movement.
Choice D rationale
Performing a log roll is the recommended technique when moving a client who is recovering from surgical spinal instrumentation for scoliosis. This technique involves the patient keeping their body in alignment while turning onto their side. It helps to maintain the integrity of the spinal fusion and prevent injury to the surgical site.