A nurse is caring for a female client who is receiving intravenous gentamicin. Which of the following laboratory values is the priority to report to the provider?
Hgb 11.5 g/dL (12 to 16 g/dL)
Creatinine 3.2 mg/dL (0.5 to 1.1 mg/dL)
Sodium 146 mEq/L (136 to 145 mEq/L)
WBC count 12,000/mm3 (5,000 to 10,000/mm3)
The Correct Answer is B
A. Hgb 11.5 g/dL (12 to 16 g/dL): While this hemoglobin level is slightly below normal, it is not an immediate priority compared to other more concerning values. Anemia could be addressed later with appropriate interventions but is not life-threatening in this case.
B. Creatinine 3.2 mg/dL (0.5 to 1.1 mg/dL): A creatinine level of 3.2 mg/dL is significantly elevated and indicates possible kidney dysfunction or acute kidney injury. Gentamicin is known to be nephrotoxic, and this level requires prompt attention to prevent further renal damage.
C. Sodium 146 mEq/L (136 to 145 mEq/L): Sodium levels are only slightly elevated and do not represent an immediate concern unless the client has symptoms of hypernatremia (e.g., confusion, seizures). While monitoring is required, it is not as urgent as the creatinine.
D. WBC count 12,000/mm3 (5,000 to 10,000/mm3): A WBC count of 12,000/mm3 is mildly elevated, which could suggest an infection or inflammation. However, this is not the priority compared to the kidney function, which could be compromised by gentamicin therapy.
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Related Questions
Correct Answer is C
Explanation
A. Hypotension: While hypotension can be a concern with opioid use, it is less immediately life-threatening compared to respiratory depression, which is the most dangerous side effect of morphine. Monitoring BP is important, but the priority is airway and breathing.
B. Bradycardia: Bradycardia is a possible side effect of morphine, but it does not usually present an immediate risk to the client's life unless it is severe. Respiratory depression poses a greater risk to the client’s oxygenation status.
C. Bradypnea: Bradypnea (slow breathing) is the most critical concern when a client is receiving morphine. Opioids like morphine can cause respiratory depression, which can be life-threatening. This should be the nurse's priority to assess and address immediately.
D. Pruritus: Pruritus (itching) is a common side effect of morphine, but it is not life-threatening. While it can be uncomfortable, it does not require immediate intervention compared to respiratory depression.
Correct Answer is B
Explanation
A. Partial pressure of CO2 50 mm Hg (35 to 45 mm Hg): In DKA the partial pressure of CO2 decreases due to hyperventilation, which is the body’s compensatory mechanism to blow off CO2 and correct metabolic acidosis. A CO2 level of 50 mm Hg would suggest insufficient compensation.
B. Serum bicarbonate 9 mEq/L (21 to 28 mEq/L): In DKA, serum bicarbonate levels decrease due to the accumulation of ketoacids, leading to metabolic acidosis. A level of 9 mEq/L is significantly lower than the normal range and indicates the severity of acidosis.
C. Blood glucose 230 mg/dL (74 to 106 mg/dL): Blood glucose levels in DKA are typically much higher than 230 mg/dL. Blood glucose levels in DKA can exceed 250 mg/dL, often reaching 600 mg/dL or higher, due to insufficient insulin.
D. pH 7.5 (7.35 to 7.45): The pH in DKA is usually low, indicating acidosis. A pH of 7.5 is higher than the normal range, suggesting alkalosis, which is not consistent with DKA. Typically, the pH in DKA is below 7.35 due to metabolic acidosis.
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