Which diagnostic studies will the nurse monitor for the client being treated for sepsis? Select all that apply.
Platelet count
Urine specific gravity
Lactate level
PaO2
Serum ammonia
Correct Answer : A,C,D
Choice A reason: Monitoring platelet count is important in sepsis as thrombocytopenia can occur due to disseminated intravascular coagulation (DIC).
Choice B reason: Urine specific gravity is not typically monitored for sepsis unless there is a concern for renal function or fluid balance.
Choice C reason: Lactate levels are monitored in sepsis to assess the severity of septic shock and tissue hypoperfusion.
Choice D reason: PaO2 is monitored to assess oxygenation status, which can be compromised in sepsis due to respiratory dysfunction.
Choice E reason: Serum ammonia is not typically monitored for sepsis unless there is a concern for hepatic function or encephalopathy.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: The ABG values provided are within normal limits and do not indicate a complication of sepsis.
Choice B reason: A temperature of 100.8°F suggests an infection but is not specific enough to indicate a complication of sepsis.
Choice C reason: A platelet count of 99,000/mm3 is below the normal range and can indicate a complication of sepsis known as disseminated intravascular coagulation (DIC), which is a serious condition that can lead to severe bleeding or blood clots.
Choice D reason: A urine culture positive for gram-negative bacteria indicates an infection, which could be the source of sepsis, but it does not specifically indicate a complication of sepsis.
Correct Answer is B
Explanation
Choice A reason: Impaired elimination may be a concern with pancreatitis due to potential complications affecting the gastrointestinal tract, but it is not the immediate priority.
Choice B reason: Fluid imbalance is the most critical issue in acute pancreatitis, as evidenced by inelastic skin turgor and concentrated urine, indicating dehydration, which can exacerbate the condition and lead to hypovolemic shock.
Choice C reason: Fever may be present due to inflammation or infection, but the temperature provided is not indicative of a significant fever and is not the priority over fluid imbalance.
Choice D reason: Nausea is a symptom of acute pancreatitis and while it needs to be managed, it is not the priority over fluid imbalance.
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