The practical nurse (PN) reviews the laboratory results of an elderly female client who is one day postoperative for a right total hip replacement (THR). Which serum value result has the greatest implication for client safety?
Reference ranges
Hemoglobin (Hgb) [12 to 16 g/dL (120 to 160 g/L)]
Potassium (K+) [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]
Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]
Hemoglobin 8.9 grams/dL.
Sodium 130 mEq/L.
Potassium 3.4 mEq/L.
Blood urea nitrogen 20 mg/dL.
The Correct Answer is A
A. Hemoglobin 8.9 grams/dL: This value is significantly below the normal range and indicates anemia, likely from perioperative blood loss. Low hemoglobin can compromise oxygen delivery to tissues, increase risk for hypoxia, delay healing, and may require urgent intervention such as transfusion or close monitoring.
B. Sodium 130 mEq/L: Mild hyponatremia requires monitoring and assessment for symptoms like confusion or weakness, but it is generally less immediately life-threatening than significant anemia in a postoperative client.
C. Potassium 3.4 mEq/L: Mild hypokalemia may predispose the client to arrhythmias, but it is not as immediately critical as severe anemia affecting oxygen-carrying capacity. Monitoring and potassium replacement can be implemented.
D. Blood urea nitrogen 20 mg/dL: This value is at the upper limit of normal and does not indicate acute renal compromise. While it warrants monitoring, it does not pose an immediate threat to client safety in the postoperative setting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Hematuria: Hematuria, often described by parents as cola- or tea-colored urine, is the hallmark sign of acute glomerulonephritis. It results from glomerular inflammation that allows red blood cells to leak into the urine. This visible change in urine color commonly prompts parents to seek medical attention.
B. Polydipsia: Increased thirst is more typical of diabetes mellitus or diabetes insipidus, not glomerulonephritis. Children with glomerulonephritis usually experience fluid retention rather than excessive thirst due to reduced kidney filtration and sodium retention.
C. A sore throat: A sore throat often precedes acute glomerulonephritis because the infection is commonly caused by group A beta-hemolytic Streptococcus. However, by the time glomerulonephritis develops, the sore throat has usually resolved, so it is not the primary reason parents seek care.
D. Weight loss: Weight loss is not typical of acute glomerulonephritis; instead, children often present with weight gain from fluid retention. The sudden presence of dark urine and swelling are more likely to alert parents to a kidney problem.
Correct Answer is ["8"]
Explanation
Identify the capillary blood glucose (CBG) reading at 1630.
CBG at 1630 = 295 mg/dL.
Refer to the Insulin aspart (Novolog) sliding scale prescription to find the corresponding dose for the glucose reading.
Sliding Scale Range: 251-300 mg/dL
Corresponding Dose: give 8 units
The dose of Insulin aspart (Novolog) to administer is 8 units.
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