Which laboratory result of a preoperative client should the nurse report to the surgeon’s office, knowing that it could cause surgery to be postponed?

Hemoglobin, 8.0 g/dL

Serum creatinine, 0.8 mg/dL

Platelets, 210,000/mm³

Sodium, 144 mEq/L

Answer and Explanation

The Correct Answer is A

Choice A reason:

Hemoglobin, 8.0 g/dL: Hemoglobin is a critical component of red blood cells, responsible for carrying oxygen throughout the body. Normal hemoglobin levels typically range from 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women1. A level of 8.0 g/dL is significantly below the normal range, indicating anemia. Severe anemia can increase the risk of perioperative complications, including poor wound healing, increased risk of infection, and cardiovascular stress. Therefore, this result should be reported to the surgeon as it may necessitate postponing the surgery until the anemia is addressed.

Choice B reason:

Serum creatinine, 0.8 mg/dL: Creatinine is a waste product produced by muscles and filtered out of the blood by the kidneys. Normal serum creatinine levels range from 0.74 to 1.35 mg/dL for men and 0.59 to 1.04 mg/dL for women. A level of 0.8 mg/dL falls within the normal range, indicating normal kidney function. Therefore, this result would not typically cause surgery to be postponed.

Choice C reason:

Platelets, 210,000/mm³: Platelets are essential for blood clotting. Normal platelet counts range from 150,000 to 400,000/mm³. A count of 210,000/mm³ is within the normal range, indicating adequate clotting ability. Thus, this result would not be a reason to postpone surgery.

Choice D reason:

Sodium, 144 mEq/L: Sodium is an essential electrolyte that helps regulate fluid balance, nerve function, and muscle contractions. Normal sodium levels range from 135 to 145 mEq/L. A level of 144 mEq/L is within the normal range, indicating normal electrolyte balance. Therefore, this result would not typically cause surgery to be postponed.

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Correct Answer is D

Explanation

Choice A reason:

Administering oxygen per the prescriber’s order to keep SpO2 greater than 96% is not typically recommended for clients with chronic bronchitis. High levels of oxygen can suppress the respiratory drive in clients with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis. The target SpO2 for these clients is usually between 88% and 92%.

Choice B reason:

Placing the patient in the Sims position is not the most effective position for airway clearance. The Fowler’s or semi-Fowler’s position is generally preferred as it promotes better lung expansion and facilitates easier breathing.

Choice C reason:

Assessing the client’s use of a peak expiratory flow rate meter is important for monitoring the severity of bronchospasm and airflow obstruction. However, it is not a direct intervention for improving gas exchange.

Choice D reason:

Assisting with coughing and deep breathing at least every 2 hours while awake is an effective intervention for clients with chronic bronchitis. This helps to mobilize secretions, improve ventilation, and enhance gas exchange. Regular coughing and deep breathing exercises can prevent atelectasis and reduce the risk of respiratory infections.

A. Fever and bradypnea B. Dyspnea and wheezing C. Crackles and productive cough D. Normal chest shape and orthopnea

Correct Answer is B

Explanation

Choice A reason:

Fever and bradypnea are not typical manifestations of asthma. Fever is more commonly associated with infections, and bradypnea (abnormally slow breathing) is not a characteristic symptom of asthma.

Choice B reason:

Dyspnea (shortness of breath) and wheezing are hallmark symptoms of asthma. Asthma is characterized by inflammation and narrowing of the airways, which leads to difficulty breathing and a whistling sound (wheezing) when exhaling. These symptoms are often triggered by allergens, exercise, or respiratory infections.

Choice C reason:

Crackles and a productive cough are more indicative of conditions like pneumonia or chronic bronchitis rather than asthma. Asthma typically involves a dry cough rather than a productive one.

Choice D reason:

A normal chest shape and orthopnea (difficulty breathing when lying flat) are not specific to asthma. While some individuals with severe asthma may develop a barrel chest over time due to chronic overinflation of the lungs, this is not a typical early manifestation.

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Which laboratory result of a preoperative client should the nurse report to the surgeon’s office, knowing that it could cause surgery to be postponed?

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