A nurse is reviewing a client's laboratory values. Which of the following values should the nurse report to the provider?

Choice A Reason: This is incorrect. Widening pulse pressure is not a sign of hypovolemic shock, but rather of increased intracranial pressure or aortic regurgitation. Hypovolemic shock causes narrowing pulse pressure due to decreased stroke volume and increased peripheral resistance.

Choice B Reason: This is correct. Increased heart rate is a sign of hypovolemic shock, as the body tries to compensate for the decreased blood volume and cardiac output by increasing the heart rate and contractility.

Choice C Reason: This is incorrect. Increased deep tendon reflexes are not a sign of hypovolemic shock, but rather of hyperreflexia or tetany. Hypovolemic shock causes decreased deep tendon reflexes due to reduced perfusion and oxygenation of the muscles and nerves.

Choice D Reason: This is incorrect. Pulse oximetry 96% is not a sign of hypovolemic shock, but rather of normal oxygen saturation. Hypovolemic shock causes decreased pulse oximetry due to hypoxia and impaired gas exchange.

Choice A: Troponin I is a laboratory test that the nurse should anticipate the provider to prescribe. Troponin I is a protein that is released into the blood when the heart muscle is damaged. Troponin I levels are elevated in clients who have acute myocardial infarction (AMI), which is a heart atack caused by a blockage of blood flow to the heart. Chest pressure and shortness of breath are common signs and symptoms of AMI. Troponin I is a specific and sensitive marker of cardiac injury and can help diagnose AMI and guide treatment.

Choice B: Aspartate aminotransferase (AST) is not a laboratory test that the nurse should anticipate the provider to prescribe. AST is an enzyme that is found in various tissues, such as the liver, heart, skeletal muscle, and kidneys. AST levels are elevated in clients who have liver damage, hepatitis, cirrhosis, or alcohol abuse. AST levels can also be elevated in clients who have AMI, but they are not as specific or sensitive as troponin I. AST is not a reliable indicator of cardiac injury and can be influenced by other factors.

Choice C: B-type natriuretic peptide (BNP) is not a laboratory test that the nurse should anticipate the provider to prescribe. BNP is a hormone that is secreted by the heart when it is stretched or overloaded. BNP levels are elevated in clients who have heart failure, which is a condition in which the heart cannot pump enough blood to meet the

body's needs. Shortness of breath can be a sign of heart failure, but chest pressure is not. BNP is not a specific or sensitive marker of cardiac injury and can be influenced by other factors.

Choice D: Lipase is not a laboratory test that the nurse should anticipate the provider to prescribe. Lipase is an enzyme that is produced by the pancreas and helps digest fats. Lipase levels are elevated in clients who have pancreatitis, which is an inflammation of the pancreas. Pancreatitis can cause abdominal pain, nausea, vomiting, and fever. Chest pressure and shortness of breath are not signs of pancreatitis. Lipase is not a specific or sensitive marker of cardiac injury and has no relation to AMI.