A nurse is assisting with the care of a client in an emergency department (ED).

Which of the following laboratory findings should the nurse report to the provider? Select all that apply.

Potassium

Hematocrit

Sodium

AST

WBC count

Answer and Explanation

Correct Answer : D,E

A. Potassium: The client’s potassium level is 4.1 mEq/L, which is within the normal range of 3.5–5 mEq/L. No immediate intervention is required, so this value does not need to be reported.

B. Hematocrit: The client’s hematocrit is 44%, which falls within the normal reference range of 37–47% for adults. This level is not clinically concerning and does not require reporting.

C. Sodium: The client’s sodium level is 140 mEq/L, which is within the normal range of 136–145 mEq/L. This electrolyte level is stable and does not require provider notification.

D. AST: The client’s AST is 42 U/L, slightly above the reference range of 0–35 U/L. Elevated AST may indicate hepatocellular injury or inflammation, possibly related to gallbladder disease or liver involvement, and should be reported for further evaluation.

E. WBC count: The client’s WBC count is 15,100/mm³, which is above the normal range of 5,000–10,000/mm³. Leukocytosis can indicate infection or inflammation, consistent with the client’s abdominal pain and possible biliary or gastrointestinal pathology, and requires provider notification.

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Correct Answer is A

Explanation

A. Decreased heart rate: Propranolol is a nonselective beta-adrenergic blocker that reduces sympathetic stimulation of the heart, resulting in decreased heart rate and cardiac output. Bradycardia is a common adverse effect and requires monitoring, especially in clients with preexisting conduction abnormalities.

B. Sudden weight loss: Propranolol does not directly promote weight loss. Any changes in weight are typically related to underlying disease or lifestyle, not a pharmacologic effect of this medication.

C. White patches on the tongue: Oral candidiasis or leukoplakia are unrelated to propranolol therapy. These findings are not associated with beta-blocker use and would suggest a separate oral health issue.

D. Increased urinary output: Propranolol does not have diuretic properties and does not directly affect renal fluid excretion. Changes in urine volume are not a known adverse effect of beta-blockers.

A. Hypocalcemia B. Atelectasis C. Hypertension D. Urinary stasis E. Pressure ulcer F. Diarrhea G. Contractures H. calcium resorption

Correct Answer is ["B","D","E","G","H"]

Explanation

A. Hypocalcemia: Prolonged immobility is more commonly associated with calcium loss from bones into the bloodstream rather than decreased serum calcium levels. Neuromuscular inactivity does not typically produce hypocalcemia as a primary complication.

B. Atelectasis: Immobility and prolonged bed rest reduce lung expansion and impair effective ventilation. Decreased chest wall movement increases the risk of alveolar collapse, especially when the client avoids repositioning. This places the client at risk for impaired gas exchange.

C. Hypertension: Blood pressure is within normal limits, and immobility does not directly cause elevated blood pressure. Cardiovascular deconditioning may occur, but hypertension is not an expected immobility-related complication.

D. Urinary stasis: Reduced mobility interferes with complete bladder emptying and normal voiding patterns. Urinary stasis increases the risk for urinary tract infection and bladder distention. Clients with multiple sclerosis are particularly vulnerable due to neurogenic bladder dysfunction.

E. Pressure ulcer: Refusal to turn or change position places sustained pressure on bony prominences, impairing tissue perfusion. Prolonged pressure leads to ischemia, skin breakdown, and ulcer formation. This is a major and immediate risk in immobile clients.

F. Diarrhea: Decreased mobility is more commonly associated with constipation due to slowed gastrointestinal motility. Diarrhea is not a typical complication of immobility or positioning refusal.

G. Contractures: Prolonged positioning without movement leads to muscle shortening and joint stiffness. Lack of range-of-motion activity accelerates the development of fixed joint deformities. Clients with neurologic disease are at especially high risk.

H. Calcium resorption: Immobility causes increased bone demineralization due to lack of weight-bearing activity. Calcium is released from bones into the bloodstream, increasing fracture risk over time. This is a well-recognized complication of prolonged immobility.

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A nurse is assisting with the care of a client in an emergency department (ED). Which of the following laboratory findings should the nurse report to the provider? Select all that apply.

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