A nurse is reviewing the laboratory results of an adolescent who has diabetes mellitus. For which of the following values should the nurse notify the provider?
Hematocrit 36%.
Hemoglobin 12 g/dL.
Glucose 120 mg/dL.
HbA1c 10.7%.
The Correct Answer is D
Choice A rationale:
Hematocrit 36%. A hematocrit level of 36% falls within the normal range for adolescents. Hematocrit measures the proportion of blood volume occupied by red blood cells and is used to assess for anemia or polycythemia. A level of 36% is not a cause for concern in this case.
Choice B rationale:
Hemoglobin 12 g/dL. A hemoglobin level of 12 g/dL is within the normal range for adolescents. Hemoglobin is a protein in red blood cells that carries oxygen. This level indicates that the adolescent is not significantly anemic.
Choice C rationale:
Glucose 120 mg/dL. A glucose level of 120 mg/dL is within the normal range for a random blood glucose test. However, in the context of diabetes mellitus, the nurse should be more concerned about the HbA1c level, which reflects the average blood glucose level over the past few months.
Choice D rationale:
HbA1c 10.7%. HbA1c, or glycated hemoglobin, reflects the average blood glucose concentration over a span of approximately 2 to 3 months. An HbA1c level of 10.7% is significantly elevated and indicates poor long-term glucose control. This value suggests that the adolescent's diabetes management has not been effective, which can lead to an increased risk of diabetes-related complications over time. The nurse should notify the healthcare provider so that appropriate adjustments can be made to the treatment plan.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A history of frequent urinary tract infections (UTIs) is a sign of child maltreatment. It may indicate sexual abuse, which can introduce bacteria into the urinary tract.Sexual abuse may also cause genital or anal trauma, sexually transmitted infections, or pregnancy1. UTIs are uncommon in children, especially in boys.The normal frequency of UTIs in children is around 1 in 10 girls and 1 in 30 boys by the age of 16 years
Correct Answer is A
Explanation
Choice A rationale:
Pain following range-of-motion exercises is a significant finding that should be reported to the provider. It could indicate the possibility of complications, such as further injury or impaired healing. Adolescents with fractured bones are often encouraged to perform range-of-motion exercises to prevent stiffness and promote circulation. However, increased pain during or after these exercises could indicate problems like muscle strain or improper alignment of the fracture, which need to be addressed promptly.
Choice B rationale:
Pruritus (itching) under the cast is common and can be expected due to the accumulation of dead skin cells and sweat. While it can be uncomfortable for the client, it's not an urgent concern that requires immediate reporting to the provider. Strategies to alleviate itching, such as using a cool blow dryer under the cast, can be taught to the client.
Choice C rationale:
The presence of swelling while the extremity is dependent is a normal response to gravity and is not an alarming finding. Swelling when the extremity is dependent is expected, especially within the initial stages of fracture healing. It suggests that the blood supply is reaching the area for healing purposes. Elevation and rest can help reduce the swelling.
Choice D rationale:
Coolness of the toes could be due to reduced blood flow, but this finding alone may not be an immediate concern. It's essential to consider the client's overall circulation, capillary refill, and presence of pulses. If other signs of impaired circulation, such as pallor or delayed capillary refill, are present along with coolness, it might indicate compromised vascular supply. However, based on the information provided, this choice is not as urgent as reporting pain following range-of-motion exercises.
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