A nurse is reviewing the diagnostic test results of an older adult female client who is preoperative for a knee arthroplasty. The nurse should notify the surgeon of which of the following results?
Hematocrit 40%
Creatinine 0.9 mg/dL
WBC count 20,000/mm3
Potassium 3.8 mEq/L
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Postoperative patients often experience muscle tension and discomfort due to lying in one position for an extended period. A gentle back massage can help relieve muscle stiffness, promote relaxation, and improve circulation. It is a non-invasive comfort measure that can enhance the client's overall well- being.
B. Teaching relaxation techniques such as deep breathing exercises, guided imagery, or progressive muscle relaxation can help the client manage pain, reduce anxiety, and promote faster recovery. These techniques are beneficial postoperatively as they encourage relaxation and improve overall comfort.
C. Postoperative clients are at risk of developing respiratory complications such as atelectasis (partial lung collapse) or pneumonia due to shallow breathing or inadequate lung expansion. Coughing and deep breathing exercises help to clear secretions, improve lung function, and prevent respiratory complications. It is typically recommended to perform these exercises every hour to maintain lung expansion and prevent complications.
D. Encouraging the client to turn every 2 hours (D), not every 4 hours, is essential to prevent pressure ulcers and promote circulation.
E. Postoperative pain management is essential for the client's comfort and recovery. Pain can interfere with the client's ability to cough, deep breathe, and move effectively, which may increase the risk of complications. Administering analgesics as needed helps to control pain, improve overall comfort, and promote participation in necessary activities such as coughing, deep breathing, and turning.
Correct Answer is C
Explanation
A. Postoperative ileus and significant drainage via an NG tube are more likely to lead to electrolyte losses rather than elevated levels. Elevated magnesium levels are less common and typically associated with conditions such as renal failure or excessive magnesium intake.
B. Calcium levels can be affected by gastrointestinal losses, including drainage via an NG tube. Significant fluid loss can lead to hemoconcentration, potentially causing a relative increase in calcium levels initially. However, prolonged fluid loss can lead to overall depletion of electrolytes, including calcium.
C. When fluids are lost through the NG tube, potassium, which is an intracellular electrolyte, can be lost in large amounts. Prolonged drainage can lead to hypokalemia (decreased potassium levels), which can result in muscle weakness, cardiac dysrhythmias, and other serious complications.
D. Elevated sodium levels (hypernatremia) are more commonly associated with dehydration or excessive sodium intake rather than drainage via an NG tube. In this scenario, sodium levels are less likely to be affected compared to potassium.
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