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 C

Explanation

A. A hematocrit of 40% is within the normal range for females, which is typically around 37-47%. This result is not concerning and does not typically require immediate notification to the surgeon.
B. A creatinine level of 0.9 mg/dL is within the normal range for adults (normal range varies slightly among laboratories but is generally around 0.5-1.1 mg/dL). This result indicates normal kidney function and does not require immediate notification.
C. A white blood cell (WBC) count of 20,000/mm3 is elevated above the normal range, which is typically between 4,500-11,000/mm3. An elevated WBC count could indicate infection or inflammation. Given the client is preoperative, an elevated WBC count may suggest an underlying infection that needs to be addressed before proceeding with surgery. The nurse should notify the surgeon promptly so appropriate evaluation and management can be initiated.
D. A potassium level of 3.8 mEq/L is within the normal range (normal range is generally 3.5-5.0 mEq/L). This result is not concerning and does not require immediate notification to the surgeon.

A. A client who has diarrhea B. A client who has salicylate intoxication C. A client who is vomiting D. A client who is taking a thiazide diuretic

Correct Answer is A

Explanation

A. Diarrhea can lead to loss of bicarbonate from the body, resulting in metabolic acidosis. The loss of bicarbonate through gastrointestinal fluids causes an imbalance between acids and bases in the body.
B. Salicylates (such as aspirin) can cause metabolic acidosis by several mechanisms, including direct stimulation of the respiratory center in the brainstem (leading to hyperventilation and respiratory alkalosis initially) and later causing metabolic acidosis due to increased production of acids like lactic acid and ketoacids.
C. Vomiting can lead to loss of gastric acid (hydrochloric acid), which could initially lead to metabolic alkalosis due to loss of acid.
D. Thiazide diuretics can cause metabolic alkalosis rather than metabolic acidosis. They promote the loss of potassium and hydrogen ions (acid), leading to increased blood pH (alkalosis).

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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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