When caring for a client with pre-eclampsia, which laboratory result should the nurse report to the physician immediately?

Platelets 50,000/mm.

Hemoglobin 11 grams/dL.

Creatinine 0.3 mg/dL.

Fasting blood glucose 65 mg/dL.

Answer and Explanation

The Correct Answer is A

Choice A rationale

A platelet count of 50,000/mm³ is critically low (normal range is 150,000-450,000/mm³) in a client with pre-eclampsia. Thrombocytopenia is a serious complication of pre-eclampsia and can significantly increase the risk of bleeding and hemorrhage. This finding requires immediate reporting and intervention.

Choice B rationale

A hemoglobin level of 11 grams/dL is within the lower end of the normal range for postpartum women (typically 12-15 g/dL) and is not an immediate concern in the context of pre-eclampsia, unless there is a rapid decline or other concerning symptoms.

Choice C rationale

A creatinine level of 0.3 mg/dL is below the normal range for non-pregnant adults (typically 0.6-1.2 mg/dL) and might be lower in pregnancy due to increased glomerular filtration rate. While kidney function should be monitored in pre-eclampsia, this specific value is not immediately alarming.

Choice D rationale

A fasting blood glucose of 65 mg/dL is within the normal range (typically 70-100 mg/dL) and is not a typical finding that requires immediate reporting in pre-eclampsia, although gestational diabetes can sometimes coexist.

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Correct Answer is B

Explanation

Choice A rationale

A glucose reading of 58 mg/dL in a newborn is below the normal range (typically 40-60 mg/dL in the first hours of life, rising to 50-90 mg/dL). While it requires attention and intervention to prevent hypoglycemia, it is not as immediately life-threatening as a significantly low temperature.

Choice B rationale

A temperature of 97.4°F (36.3°C) in a newborn is below the normal range (typically 97.7°F to 99.5°F or 36.5°C to 37.5°C). Hypothermia in a newborn can lead to cold stress, increased oxygen consumption, and hypoglycemia. This newborn needs immediate assessment and warming measures to prevent complications.

Choice C rationale

A respiratory rate of 48 breaths per minute is within the normal range for a newborn (typically 30-60 breaths per minute). While the nurse will continue to monitor the respiratory status, this finding does not indicate immediate distress.

Choice D rationale

A pulse rate of 134 beats per minute is within the normal range for a newborn (typically 110-160 beats per minute). While the nurse will continue to monitor the cardiovascular status, this finding does not indicate immediate distress. .

A. Mongolian spots. B. Lanugo. C. Nevus flammeus. D. Vascular nevus.

Correct Answer is A

Explanation

Choice A rationale

Mongolian spots are benign, flat bluish or bluish-gray birthmarks that commonly appear on the buttocks, lower back, or thighs of newborns, particularly those with darker skin tones, including African Americans, Asians, and Hispanics. They are caused by the entrapment of melanocytes (pigment-producing cells) deep within the dermis during fetal development. These spots typically fade spontaneously within a few years and are not indicative of any underlying medical condition or trauma.

Choice B rationale

Lanugo is fine, downy hair that covers the body of some newborns, especially preterm infants. It is usually shed within the last few weeks of gestation or shortly after birth and is unrelated to bruising or pigmented spots on the buttocks.

Choice C rationale

Nevus flammeus, also known as a port-wine stain, is a vascular malformation of the skin that appears as a flat, pink, red, or purple birthmark. It is caused by dilated capillaries and does not typically occur as bluish spots on the buttocks. Port-wine stains are usually permanent and may darken with age.

Choice D rationale

Vascular nevus, also known as a strawberry hemangioma, is a raised, red, bumpy birthmark composed of extra blood vessels. While it is a type of birthmark, it does not present as flat, bluish spots on the buttocks. Hemangiomas typically grow rapidly in the first few months of life and then gradually shrink over several years.

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When caring for a client with pre-eclampsia, which laboratory result should the nurse report to the physician immediately?

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