The practical nurse (PN) is providing care for a client suspected of adrenal cortex failure. Which laboratory value would indicate the functioning of the adrenal gland?

Choice A reason: Administering a PRN prescription for an antiemetic might help with the nausea and vomiting, but it is not the first action to take. The primary concern should be addressing a potential transfusion reaction.
Choice B reason: Flushing the IV tubing with sodium chloride is an important step to clear the line of any remaining blood product, but this should be done after stopping the infusion to prevent further administration of the blood.
Choice C reason: Notifying the healthcare provider is crucial, but the first and most immediate action should be to stop the blood infusion to prevent further reaction.
Choice D reason: Turning off the blood infusion is the first and most critical action to take. Shaking, nausea, and vomiting can be signs of a transfusion reaction, and halting the infusion immediately helps prevent further complications. Following this, the nurse should notify the healthcare provider and take other appropriate measures.

Choice A reason: Facial pallor, particularly around the lips, could indicate anemia or poor perfusion, but it is not the most urgent finding in this context. Polycythemia vera typically involves an overproduction of red blood cells, which can actually result in a ruddy complexion rather than pallor. While pallor should be monitored, it does not require immediate reporting compared to other potential complications of polycythemia vera.
Choice B reason: An increased heart rate over the last 4 hours could be a sign of various conditions, such as dehydration, fever, or cardiovascular stress. However, in the context of polycythemia vera, it is not as immediately concerning as symptoms that might indicate thrombotic complications, which are a common and serious risk for these patients. Tachycardia should be monitored, but it is not the most critical finding needing immediate attention.
Choice C reason: Dark brown stools could indicate the presence of digested blood, suggesting gastrointestinal bleeding. While this is an important finding that requires further investigation, it is not as immediately life-threatening as signs of deep vein thrombosis (DVT) in a client with polycythemia vera. Bleeding risks do exist with this condition, but the urgency of DVT symptoms demands prompt intervention to prevent further complications, such as a pulmonary embolism.
Choice D reason: Right lower leg redness and edema are classic signs of deep vein thrombosis (DVT). Clients with polycythemia vera are at increased risk for thrombotic events due to the hyperviscosity of their blood. Reporting this finding immediately is critical, as DVT can lead to serious complications, including pulmonary embolism, which can be life-threatening. Early detection and intervention are essential in managing thrombotic risks in polycythemia vera patients.