A nurse is caring for a client who is 8 hr postoperative following a left hip arthroplasty. Which of the following laboratory values indicates the nurse should notify the provider?
Blood glucose 98 mg/dL
BUN 18 mg/dL
Hemoglobin 8.6 g/dL
Potassium 3.5 mEq/L
The Correct Answer is C
Choice A: This is incorrect because blood glucose 98 mg/dL is within the normal range of 70 to 110 mg/dL. The nurse does not need to notify the provider for this value.
Choice B: This is incorrect because BUN 18 mg/dL is within the normal range of 10 to 20 mg/dL. The nurse does not need to notify the provider for this value.
Choice C: This is correct because hemoglobin 8.6 g/dL is below the normal range of 12 to 18 g/dL. The nurse should notify the provider for this value as it indicates anemia, which can be caused by blood loss during surgery or impaired bone marrow function.
Choice D: This is incorrect because potassium 3.5 mEq/L is within the normal range of 3.5 to 5.0 mEq/L. The nurse does not need to notify the provider for this value.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Keeping both arms below the level of the client's heart can increase venous pressure and fluid accumulation in the affected arm, which can lead to lymphedema.
Choice B reason: After a mastectomy, it’s important to avoid procedures like blood draws, injections, or blood pressure measurements on the side where the surgery was performed to prevent lymphedema. Therefore, using the client’s left arm for blood samples is a preventive measure.
Choice C reason: Obtaining blood pressure readings using the client's right arm is an incorrect action that can increase lymphatic fluid accumulation and impair circulation in the affected arm.
Choice D reason: Limiting range-of-motion exercises with the affected arm is an incorrect action that can decrease lymphatic drainage and increase swelling in the affected arm. The nurse should encourage the client to perform gentle exercises, such as squeezing a soft ball or raising and lowering the arm, to promote lymphatic flow and prevent stiffness.
Correct Answer is B
Explanation
Choice A reason: Wiping the top of the feeding container with alcohol is not a priority action, as it is not essential for infection control or safety. The nurse should use a sterile technique when opening and handling the feeding container.
Choice B reason: Placing the head of the client's bed at a 30° angle or higher is a priority action, as it can prevent aspiration or regurgitation of the feeding solution into the lungs, which can cause pneumonia or respiratory distress.
Choice C reason: Rinsing the feeding bag with water once the feeding is complete is not a priority action, as it can be done after ensuring that the client has tolerated the feeding well and has no signs of complications.
Choice D reason: Documenting the client's response to the feeding is not a priority action, as it can be done after performing other interventions and assessments that are more urgent and important for the client's well-being.
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