The nurse is reviewing serum laboratory values for a client who is scheduled for surgery tomorrow. Which value requires the nurse to promptly notify the surgeon?

Serum glucose of 118 mg/dL

Blood urea nitrogen (BUN) of 16 mg/dL

Serum sodium of 130 mEq/L

Serum potassium of 3.9 mEq/L

Answer and Explanation

The Correct Answer is C

A. Serum glucose of 118 mg/dL: This value is slightly above the normal range but not critically elevated; it does not typically require immediate notification to the surgeon.
B. Blood urea nitrogen (BUN) of 16 mg/dL: This BUN level is within the normal range and does not suggest an immediate concern for surgical risk.
C. Serum sodium of 130 mEq/L: A serum sodium level of 130 mEq/L indicates hyponatremia, which can lead to serious complications including neurological symptoms and should be addressed prior to surgery.
D. Serum potassium of 3.9 mEq/L: This level is within the normal range and does not require immediate action related to surgery.

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Correct Answer is B

Explanation

A. Tell the client he can no longer have any more pain medication: This is not appropriate. The client’s severe pain needs to be managed, but the current vital signs suggest a need for careful evaluation before administration.
B. Notify the prescribing physician: This is the correct choice. The client's blood pressure and respiratory rate are significantly low, which could be exacerbated by morphine. The physician needs to be informed to reassess pain management and possibly adjust the treatment.
C. Administer half the dose of morphine, 2 mg IV: Given the client's low blood pressure and respiratory rate, any morphine administration could worsen these issues. Adjusting the dose without physician guidance is not appropriate.
D. Administer 4 mg of morphine IV as ordered: Administering the full dose without addressing the client’s low blood pressure and respiratory rate could lead to severe complications.

A. Administer 10% sodium chloride via rapid infusion B. Administer intranasal antidiuretic hormone C. Encourage oral fluid intake D. Place the client on seizure precautions

Correct Answer is D

Explanation

A. Administer 10% sodium chloride via rapid infusion: Rapid infusion of high concentrations of sodium chloride can be dangerous and is not the standard treatment for severe hyponatremia.
B. Administer intranasal antidiuretic hormone: This would not be appropriate for correcting severe hyponatremia and could potentially worsen the condition.
C. Encourage oral fluid intake: For severe hyponatremia, oral fluid intake might not be sufficient and could exacerbate the condition if there is fluid overload.
D. Place the client on seizure precautions: This is the correct choice. Severe hyponatremia (sodium < 120 mEq/L) can lead to neurological symptoms and seizures, so implementing seizure precautions is crucial for safety.

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The nurse is reviewing serum laboratory values for a client who is scheduled for surgery tomorrow. Which value requires the nurse to promptly notify the surgeon?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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