The practical nurse (PN) reviews the laboratory results of an elderly female client who is one day postoperative for a right total hip replacement (THR).
Which serum value result has the greatest implication for client safety?
Reference ranges
- Hemoglobin (Hgb) [12 to 16 g/dL (120 to 160 g/L)]
- Potassium (K+) [3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
- Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]
- Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]
Sodium 130 mEq/L.
Hemoglobin 8.9 grams/dL.
Potassium 3.4 mEq/L
Blood urea nitrogen 20 mg/dL.
The Correct Answer is B
A. Sodium level of 130 mEq/L is slightly below the lower limit of the reference range but might not have as immediate an impact on safety as a critically low hemoglobin level.
B. Hemoglobin of 8.9 grams/dL is significantly below the normal range and indicates a substantial drop in red blood cells, which can lead to impaired oxygen transport and potentially severe postoperative complications like inadequate tissue perfusion and oxygenation.
C. Potassium level of 3.4 mEq/L is slightly below the lower limit of the reference range but might not pose an immediate threat compared to a critically low hemoglobin level.
D. Blood urea nitrogen (BUN) of 20 mg/dL is at the upper limit of the reference range but might not have an immediate implication for client safety compared to a critically low hemoglobin level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Determine the means by which residents will be evacuated. - This task requires critical decision-making and understanding of evacuation protocols, which is within the scope of the practical nurse's responsibilities.
B. Close all fire doors and the doors to all the residents' rooms. - While important for containment, this can be executed by UAP following established protocols.
C. Assist any wandering residents back to their rooms. - UAP can assist in guiding residents back to their rooms safely.
D. Offer comfort and reassurance to distraught residents. - Both PN and UAP can offer comfort and reassurance to residents during such situations.
Correct Answer is D
Explanation
A. Including guidelines for coping in the discharge plan might be important but doesn’t address the immediate concern of the client having access to a potential means of self-harm.
B. Calling dietary for plastic utensils might help remove the immediate risk of harm, but informing the healthcare provider takes priority.
C. Informing the family is essential for support but doesn’t directly address the current risk.
D. Informing the healthcare provider who discharged the client is crucial as they need to reassess the discharge plan in light of the client's current statement and remove the potential means of self-harm.
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