A nurse on a medical unit is reviewing the laboratory reports for a client. Which of the following laboratory values is the priority to report to the provider?

Potassium level 3 mEq/L.

BUN 9.5 mg/dl

Creatinine 0.4 mg/dl

Sodium 135 mEq/L

Answer and Explanation

The Correct Answer is A

A) Potassium level 3 mEq/L:
A potassium level of 3 mEq/L is below the normal range (which is typically 3.5-5.0 mEq/L) and represents hypokalemia. Potassium is crucial for normal muscle and nerve function, including cardiac function. Low potassium levels can lead to dangerous arrhythmias, muscle weakness, and cardiac arrest if not addressed promptly. This is the priority value because hypokalemia can be life-threatening and requires immediate attention from the healthcare provider to correct the imbalance.

B) BUN 9.5 mg/dl:
A BUN (blood urea nitrogen) level of 9.5 mg/dL is within the normal reference range for most adults (typically 7-20 mg/dL). While an abnormal BUN level could indicate kidney dysfunction or dehydration, this value is not immediately concerning and does not represent a critical finding that requires urgent attention.

C) Creatinine 0.4 mg/dl:
A creatinine level of 0.4 mg/dL is below the normal range (usually around 0.6-1.2 mg/dL), which might indicate low muscle mass or a transient decrease in kidney function. However, a low creatinine level is generally not as urgent or concerning as an elevated level, and it does not typically require immediate intervention

D) Sodium 135 mEq/L:
A sodium level of 135 mEq/L is slightly below the normal range (135-145 mEq/L), indicating mild hyponatremia. Although this can be concerning if the drop is acute or symptomatic (e.g., causing confusion, seizures, or lethargy), a mild decrease in sodium is not immediately life-threatening unless it worsens rapidly.

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Correct Answer is B

Explanation

A) The client is underweight:
Being underweight is not directly associated with an increased risk of incisional hematoma formation. However, underweight individuals may have a lower amount of subcutaneous fat, which could affect wound healing. While nutritional status plays a role in recovery after surgery, being underweight does not specifically increase the risk of hematoma formation at
the incision site.

B) The client takes anticoagulant medications:
Taking anticoagulant medications (e.g., warfarin, heparin, or newer anticoagulants like dabigatran) increases the risk of bleeding and the formation of an incisional hematoma. Anticoagulants work by reducing the blood's ability to clot, making it more difficult to stop bleeding after surgery. This increases the likelihood of blood accumulating in the tissue around the incision site, potentially forming a hematoma.

C) The client has urinary incontinence:
Urinary incontinence does not directly increase the risk of incisional hematoma formation. However, it can lead to other complications, such as skin irritation or infection, but it is not a primary risk factor for hematoma formation in the surgical wound. The main concern with urinary incontinence in the perioperative period is ensuring proper skin care to prevent moisture-associated skin damage.

D) The client has peripheral vascular disease:
Peripheral vascular disease (PVD) affects circulation in the extremities, which can impair wound healing due to decreased blood flow. While PVD can contribute to delayed healing and complications like infection, it is not the most significant factor for the formation of incisional hematomas.

A. Chloride 112 B. Calcium 7.5 C. Potassium 4.0 D. Calcium 12.1

Correct Answer is B

Explanation

A) Chloride 112:
Chloride levels are typically not directly associated with numbness or tingling of the hands and fingers. Elevated chloride levels (greater than 108 mEq/L) may indicate metabolic acidosis, but they would not directly explain the symptoms seen in this client following parathyroidectomy. Therefore, this value is unlikely to be relevant in this scenario.

B) Calcium 7.5:
After the partial removal of the parathyroid glands, the client may experience hypocalcemia, or low calcium levels, due to the reduced production of parathyroid hormone (PTH). PTH helps regulate calcium levels in the blood. When the parathyroid glands are removed or damaged, there may be insufficient PTH to maintain normal calcium levels, leading to hypocalcemia. Symptoms of hypocalcemia include numbness and tingling, especially in the hands and fingers. A calcium level of 7.5 mg/dL is below the normal range (8.5–10.5 mg/dL), indicating hypocalcemia, which is consistent with the patient's symptoms.

C) Potassium 4.0:
A potassium level of 4.0 mEq/L is within the normal range (3.5–5.0 mEq/L) and does not typically cause numbness or tingling. Although potassium imbalances can cause neuromuscular symptoms, they would not be the most likely cause of the symptoms in this case, especially in relation to parathyroidectomy.

D) Calcium 12.1:
A calcium level of 12.1 mg/dL is elevated and would suggest hypercalcemia. Hypercalcemia can cause symptoms like fatigue, confusion, and weakness, but it does not typically cause numbness and tingling in the hands and fingers. Elevated calcium levels are more likely to occur in conditions such as hyperparathyroidism or malignancy, not typically following parathyroid gland removal. Therefore, this is not the expected lab result in this scenario.

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A nurse on a medical unit is reviewing the laboratory reports for a client. Which of the following laboratory values is the priority to report to the provider?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

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