A nurse is reviewing the lab results of a client with suspected acute pancreatitis.
Which additional lab results would support this diagnosis? Select all that apply.
Elevated WBC count.
Decreased hematocrit.
Decreased serum amylase.
Elevated serum lipase.
Elevated serum triglycerides.
Elevated serum glucose.
Correct Answer : A,D,E,F
Diagnosing acute pancreatitis involves analyzing inflammatory markers, pancreatic enzymes, and metabolic changes. Knowledge of systemic inflammatory response syndrome and the endocrine/exocrine functions of the pancreas is necessary to identify labs indicating tissue necrosis, inflammation, and secondary metabolic disturbances.
Choice A rationale
Pancreatitis triggers a systemic inflammatory response, leading to leukocytosis. An elevated white blood cell count (normal range 5,000 to 10,000 cells/mm) is a common finding indicating active inflammation or secondary infection within the pancreatic tissue.
Choice B rationale
In acute pancreatitis, hematocrit often increases rather than decreases due to hemoconcentration. Fluid shifts from the intravascular space into the peritoneal cavity (third spacing) cause a relative rise in hematocrit, indicating significant volume depletion.
Choice C rationale
Serum amylase (normal range 30 to 110 U/L) typically increases rapidly within hours of symptom onset in pancreatitis. A decreased level is not supportive of this diagnosis; levels usually rise three times the upper limit.
Choice D rationale
Serum lipase (normal range 0 to 160 U/L) is a highly specific marker for pancreatic damage. In acute pancreatitis, lipase levels rise significantly and remain elevated longer than amylase, making it a primary diagnostic indicator.
Choice E rationale
Hypertriglyceridemia is both a cause and a result of acute pancreatitis. Serum triglycerides exceeding 1,000 mg/dL can precipitate an attack. Elevated levels support the diagnosis and help identify the potential underlying metabolic etiology.
Choice F rationale
The pancreas produces insulin via islets of Langerhans. Inflammation impairs endocrine function, leading to hyperglycemia (normal fasting glucose 70 to 99 mg/dL). Elevated glucose is a common secondary finding in acute pancreatic injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The management of indwelling urinary catheters requires strict adherence to evidence-based practices to prevent catheter-associated urinary tract infections. This scenario involves applying knowledge of aseptic technique, mechanical drainage patency, and the prevention of bacterial colonization within the urinary system.
Choice A rationale
Regular irrigation increases the risk of introducing pathogens into the sterile urinary tract by breaking the closed drainage system. Irrigation is only indicated for obstructions, such as blood clots, to maintain necessary catheter patency.
Choice B rationale
Daily perineal care should be performed with soap and water rather than antiseptic solutions. Antiseptics can irritate the urethral meatus and disrupt normal flora, potentially increasing the risk of bacterial overgrowth and subsequent infection.
Choice C rationale
Maintaining a prompt and unobstructed flow of urine is vital. Kinks or twists cause urine stasis, which allows bacteria to migrate upward into the bladder, significantly increasing the risk of developing a urinary tract infection.
Choice D rationale
Catheters should only be replaced based on clinical indications, such as obstruction or infection, not on a fixed schedule. Frequent, unnecessary changes increase the risk of urethral trauma and the introduction of exogenous microorganisms.
Correct Answer is A
Explanation
Pyloric obstruction involves a mechanical blockage at the stomach outlet, leading to the accumulation of gastric contents. Knowledge of gastrointestinal decompression and the therapeutic purpose of nasogastric tubes in managing increased intragastric pressure and preventing emesis is required here.
Choice A rationale
Pyloric obstruction causes gastric stasis and distension because contents cannot enter the duodenum. Nasogastric intubation provides decompression by removing accumulated secretions and gas, which relieves pressure, prevents vomiting, and reduces the risk of aspiration in the client.
Choice B rationale
Providing nutrition via tube feeding is contraindicated in pyloric obstruction. Because the outlet of the stomach is blocked, any enteral formula introduced would accumulate in the stomach, worsening distension and significantly increasing the risk of reflux or aspiration.
Choice C rationale
While gastric pH can be measured via a nasogastric tube, it is not the primary therapeutic rationale for tube placement in a client with a mechanical obstruction. Decompression is a critical intervention to ensure safety and comfort.
Choice D rationale
Administering oral medications through a nasogastric tube is ineffective during an obstruction. The medication cannot pass the pylorus to be absorbed in the small intestine, and it adds volume to an already overfilled and pressurized stomach.
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