A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?
Oxygen saturation 96%
Decrease in protein
Increase in BP
PaCO2 30 mm Hg
The Correct Answer is C
Choice A Reason:
Oxygen saturation within this range is generally considered adequate and might not directly correlate with the administration of albumin.
Choice B Reason:
Decrease in protein is incorrect. Albumin infusions are meant to supplement protein levels in the blood, so a decrease in protein wouldn't be an expected finding.
Choice C Reason:
Increase in blood pressure is correct. Albumin infusions can potentially help increase blood volume, leading to an increase in blood pressure. In shock, where there's a significant decrease in blood pressure due to reduced circulating volume, administering albumin or other intravenous fluids can help restore blood volume and consequently raise blood pressure towards a more stable range.
Choice D Reason:
PaCO2 of 30 mm Hg is incorrect. PaCO2 levels are related to respiratory function and the amount of carbon dioxide in the blood. While shock can impact various physiological parameters, a PaCO2 level of 30 mm Hg alone might not be directly tied to the administration of albumin in shock.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
INR (International Normalized Ratio) is incorrect. INR is a measurement used to monitor the effects of anticoagulants like warfarin. It assesses the blood's ability to clot. Filgrastim does not directly affect INR levels, so monitoring INR would not provide information about the effectiveness of filgrastim in stimulating white blood cell production.
Choice B Reason:
BUN (Blood Urea Nitrogen) is incorrect. BUN levels primarily indicate kidney function and hydration status. They are not directly influenced by filgrastim treatment. Monitoring BUN is essential for assessing kidney function but does not reflect the effectiveness of filgrastim therapy in increasing white blood cell counts.
Choice C Reason:
WBC count is correct. Filgrastim is a medication that stimulates the production of white blood cells (WBCs), particularly neutrophils. Therefore, the key laboratory value to monitor for assessing the effectiveness of filgrastim therapy is the WBC count. An increase in the WBC count, particularly in the neutrophil count, signifies the intended therapeutic effect of filgrastim in boosting the immune system's response by increasing the production of these infection-fighting cells.
Choice D Reason:
Potassium level is incorrect. Potassium levels are crucial for heart and muscle function. While certain medications might affect potassium levels, filgrastim's primary action is on stimulating white blood cell production and does not directly impact potassium levels. Monitoring potassium levels is essential for overall health but does not specifically indicate the effectiveness of filgrastim treatment.

Correct Answer is C
Explanation
Choice A Reason:
"I will have my partner tilt their head back while I am instilling the drops." Is incorrect. Tilting the head back is not typically recommended for administering optic medication as it might cause the medication to flow out instead of remaining in the ear canal.
Choice B Reason:
"I will make sure the solution is cool prior to instilling the drops." Is incorrect. The temperature of the solution usually doesn't need to be adjusted before instilling optic drops unless directed otherwise by specific medication instructions or healthcare provider guidance.
Choice C Reason:
"I will pull the pinna upward and outward prior to instilling the drops." Is correct statement. Pulling the pinna (outer ear) upward and outward helps straighten the ear canal in adults, facilitating the proper administration of optic (ear) drops. This action helps ensure that the medication reaches the ear canal effectively.
Choice D Reason:
"I will have my partner lie down on their back while I am instilling the drops." Is incorrect statement.
Having the partner lie down on their back might not be necessary for administering optic medication and might not be the optimal position for effective instillation.
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