A nurse is reviewing the medical record of a client who is 1 day postoperative following an appendectomy. Which of the following findings should the nurse report to the provider?
WBC count 8,400/mm3
Reports pain of 4 on a scale from 0 to 10 when coughing
Serosanguineous exudate noted on dressing change
Hemoglobin 10 mg/dL
The Correct Answer is D
This is a low hemoglobin level, which may indicate blood loss. The nurse should report this finding to the provider immediately, as it may require further investigation and intervention, such as blood transfusion.
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Related Questions
Correct Answer is B
Explanation
Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii, which can be transmitted by contact with cat feces or eating undercooked meat containing cysts. The nurse should ask about the client's exposure to cats or cat litter, as this is a risk factor for acquiring toxoplasmosis, especially in immunocompromised individuals.
Correct Answer is B
Explanation
The correct answer is Choice B.
Choice A rationale: This choice suggests that the provider will prescribe a different medication regimen. However, this is not necessarily the case. Rifampin is a first-line medication for tuberculosis and its side effects, including the discoloration of body fluids, are well-known and expected. Therefore, it is unlikely that the provider would change the medication regimen solely based on this side effect.
Choice B rationale: This is the correct answer. Rifampin, an antibiotic used to treat tuberculosis, can cause a harmless red-orange discoloration of body fluids, including urine, sweat, tears, and saliva. This is an expected side effect of the medication and does not indicate any harm or toxicity. It is important for the nurse to reassure the client that this is a normal occurrence and does not require any changes to the medication regimen.
Choice C rationale: This choice suggests that the red-orange discoloration of the client’s saliva may indicate possible medication toxicity. However, this is not accurate. While rifampin can have serious side effects, including liver damage and severe gastrointestinal upset, the discoloration of body fluids is not a sign of toxicity. It is a harmless side effect of the medication.
Choice D rationale: This choice suggests that the client will need to increase her fluid intake to resolve the problem. However, increasing fluid intake will not change the discoloration caused by rifampin. The discoloration is a result of the medication itself and is not influenced by the client’s hydration status.
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