A nurse is caring for a client who has human immunodeficiency virus (HIV). Which of the following laboratory values would be most concerning to the nurse?

Positive Western blot test

CD4-T-cell count 505 cells/mm³ (nl. 500-1500 cells/mm³)

Platelets 115,000/mm³ (nl. 140,000-400,000/mm³)

White blood cell (WBC) count 800/mm³ (nl. 5000-10,000/mm³)

Answer and Explanation

The Correct Answer is D

A. A positive Western blot test confirms the diagnosis of HIV, but it is not concerning once the diagnosis has been established.
B. A CD4-T-cell count of 505 cells/mm³ is low but not critically low. While it does indicate immunosuppression, it is not the most concerning value presented.
C. A platelet count of 115,000/mm³ is lower than normal and may indicate a risk for bleeding, but it is not as concerning as a critically low white blood cell count.
D. A WBC count of 800/mm³ is severely low and indicates a high risk for infection, which is particularly concerning in a client with HIV, as it suggests significant immunosuppression and vulnerability to opportunistic infections.

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Correct Answer is D

Explanation

A. Placing the client on a ventilator to remove CO2 is not directly related to preventing the development of MODS. While ventilation might be necessary for respiratory support, it does not address the systemic infection and inflammation that contribute to MODS.
B. Advising the client to use their call light to reduce the risk of falls is important for general safety but does not address the critical factors involved in preventing MODS in the context of SIRS.
C. Providing a high protein diet can support overall nutrition and healing but is not the primary intervention for preventing MODS. Managing the infection and maintaining hemodynamic stability are more critical.
D. Administering antibiotics to treat the bacterial infection and maintaining a mean arterial pressure (MAP) of at least 65 mm Hg are essential interventions. Effective antibiotic therapy addresses the infection, and maintaining MAP ensures adequate organ perfusion, both of which help prevent the progression to MODS.

A. Initiate droplet precautions. B. Prepare to administer antiviral therapy. C. Assess for hemorrhage. D. Assess the respiratory system.

Correct Answer is D

Explanation

A. Droplet precautions are not appropriate for anthrax exposure. Precautions would be based on the specific form of anthrax (cutaneous, inhalation, or gastrointestinal).
B. Anthrax is treated with antibiotics, not antiviral therapy. Ciprofloxacin or doxycycline is typically used for prophylaxis and treatment.
C. While assessing for hemorrhage might be relevant in cases of severe anthrax, it is more critical initially to focus on respiratory assessment, particularly for inhalation anthrax.
D. Assessing the respiratory system is crucial for clients exposed to anthrax, particularly inhalation anthrax, as it can cause severe respiratory symptoms and complications. Prompt assessment is essential for early detection and treatment of respiratory distress.

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A nurse is caring for a client who has human immunodeficiency virus (HIV). Which of the following laboratory values would be most concerning to the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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