A nurse is reviewing laboratory results for a client who is scheduled for surgery this morning. Which of the following results will cause the nurse to place a call to the surgical team?

Potassium: 2.9 mEq/L (2.9 mm)

Creatinine: 1.2 mg/dL (106.1 umol/L)

Hemoglobin: 14.8 mg/dL (148 mmol/L)

Sodium: 134 mEq/L (134 mmol/L)

Answer and Explanation

The Correct Answer is A

A.   A potassium level of 2.9 mEq/L is below the normal range (typically 3.5-5.0 mEq/L). Abnormal potassium levels can affect cardiac function, leading to arrhythmias (irregular heartbeats), especially if the potassium level drops further or if there is rapid fluctuation. This is a critical finding that requires immediate attention from the surgical team to assess the client's cardiac status and determine if potassium replacement is needed before proceeding with surgery.
B.   Creatinine levels are used to assess kidney function. A creatinine level of 1.2 mg/dL is within the normal range (typically 0.6-1.2 mg/dL). While kidney function is important to evaluate before surgery, this result is not immediately concerning enough to require an urgent call to the surgical team.
C.   Hemoglobin levels are assessed to evaluate oxygen-carrying capacity of the blood. A hemoglobin level of 14.8 g/dL is within the normal range (typically 12-16 g/dL for women and 13-18 g/dL for men). This result indicates adequate oxygen-carrying capacity and does not require immediate communication with the surgical team.

D.   Sodium levels are important for fluid balance and nerve function. A sodium level of 134 mEq/L is within the normal range (typically 135-145 mEq/L). While sodium levels should be monitored, this result is not critically abnormal and does not necessitate an urgent call to the surgical team.

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Correct Answer is A

Explanation

A. Furosemide can increase serum uric acid levels, leading to hyperuricemia. This occurs due to the drug's effects on renal excretion of uric acid. Hyperuricemia can predispose the client to gouty arthritis or kidney stones.
B. Furosemide typically leads to sodium loss (natriuresis) rather than hypernatremia. It is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending loop of Henle in the kidneys, promoting diuresis and reducing fluid overload.
C. Furosemide-induced diuresis can cause loss of chloride ions along with sodium, potentially leading to hypochloremia rather than hyperchloremia. Hyperchloremia is less common unless there are other contributing factors such as concurrent administration of saline solutions or underlying conditions.
D. Furosemide does not typically cause hypercalcemia. In fact, it can lead to mild hypocalcemia due to increased urinary calcium excretion. Loop diuretics like furosemide impair calcium reabsorption in the kidneys, which can lead to calcium wasting.

A. Metabolic alkalosis B. Respiratory acidosis C. Metabolic acidosis D. Respiratory alkalosis

Correct Answer is A

Explanation

A. This condition occurs because the suctioning can lead to a significant loss of hydrochloric acid from the stomach. Since hydrochloric acid is one of the components that maintain the acid-base balance in the body, its loss can lead to an increase in blood pH, causing alkalosis
B. Respiratory acidosis occurs due to retention of carbon dioxide (CO2), leading to an increase in PaCO2 and a decrease in pH. In the context of a small bowel obstruction with nasogastric tube suctioning, this is less likely unless there are concurrent respiratory issues.
C. This condition occurs because the suctioning can lead to a significant loss of hydrochloric acid from the stomach. Since hydrochloric acid is one of the components that maintain the acid-base balance in the body, its loss can lead to an increase in blood pH, causing alkalosis. Acidosis is, therefore, unlikely.
D. Respiratory alkalosis occurs due to hyperventilation, leading to a decrease in PaCO2 and an increase in pH. This is less likely in the context of nasogastric tube suctioning unless there are other contributing factors.

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A nurse is reviewing laboratory results for a client who is scheduled for surgery this morning. Which of the following results will cause the nurse to place a call to the surgical team?

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