The practical nurse (PN) is evaluating a client who is admitted to the hospital with a diagnosis of cholelithiasis. Which finding should the practical nurse (PN) report to the charge nurse?

Choice A reason: Being able to ambulate without assistance is generally an indicator of improved mobility or reduced motor impairment. However, it does not directly reflect the effectiveness of carbamazepine in treating trigeminal neuralgia. Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve in the face, causing severe facial pain. The goal of carbamazepine in this context is to reduce or eliminate this pain, so ambulation is not a relevant measure of the medication's effectiveness in this case.
Choice B reason: Distal pulses that are intact with strong volume are important indicators of good peripheral circulation. While this is a positive clinical finding, it does not relate to the primary purpose of carbamazepine administration in a client with trigeminal neuralgia. The primary goal is to alleviate the facial pain associated with the condition, so assessing peripheral pulses does not indicate the desired outcome of the medication.
Choice C reason: No seizure activity observed is an important outcome in clients taking carbamazepine for seizure disorders. However, in the context of trigeminal neuralgia, carbamazepine is used primarily for its pain-relieving properties. The absence of seizure activity is not the main indicator of the medication's effectiveness for this specific condition. Therefore, while seizure control is relevant for other uses of carbamazepine, it is not the primary measure of success for treating trigeminal neuralgia.
Choice D reason: Client denies pain is the most relevant and desired outcome when administering carbamazepine for trigeminal neuralgia. This medication is effective in reducing or eliminating the severe facial pain associated with the condition. By denying pain, the client indicates that the medication is effectively managing the symptoms of trigeminal neuralgia, which is the primary therapeutic goal in this context.

Choice A reason: Flushed, hot skin is not directly related to the client's CBC results. This symptom can indicate various conditions, such as fever, inflammation, or an allergic reaction, but it does not specifically correlate with the lab findings provided. The client's WBC count, hemoglobin, hematocrit, and basophils are within normal ranges, and the most significant abnormality is the low platelet count.
Choice B reason: Hives, or urticaria, are typically associated with allergic reactions and not directly related to the client's CBC results. While a low platelet count can sometimes be associated with immune-mediated conditions, hives are not a primary symptom of thrombocytopenia (low platelet count). The main concern with a low platelet count is the increased risk of bleeding and bruising.
Choice C reason: Inelastic turgor is a sign of dehydration or poor skin elasticity, often seen in conditions such as severe dehydration or malnutrition. The client's CBC results do not indicate dehydration or issues with skin turgor. The hemoglobin and hematocrit levels are within normal ranges, suggesting that the client's overall fluid status is likely stable.
Choice D reason: Bruising is the most relevant finding to assess for in a client with a low platelet count (thrombocytopenia). Platelets play a crucial role in blood clotting, and a low platelet count increases the risk of bleeding and easy bruising. The client's platelet count of 98,000/mm³ (98 x 10⁹/L) is below the normal range, which predisposes them to bruising and potential bleeding complications. It is important for the practical nurse to assess for signs of bruising and bleeding and to monitor the client closely for any further complications.