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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)]

A.

Sodium 130 mEq/L.

B.

Hemoglobin 8.9 grams/dL.

C.

Potassium 3.4 mEq/L

D.

Blood urea nitrogen 20 mg/dL.

Answer and Explanation

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. 
 


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Related Questions

Correct Answer is B

Explanation

A. Asking about the bowel sterilization prescription doesn't address the client's concern regarding the visibility of the surgical opening.
B. Reviewing the client's expectations after surgery could address the client's query about the visibility of the surgical opening and offer information regarding elimination.
C. Verifying the NPO status is important for surgery preparation but doesn’t directly address the client's specific concern.
D. Determining if this is the first indwelling catheter doesn’t directly address the client's immediate concern regarding the surgical opening.

Correct Answer is C

Explanation

A. Evaluating a client's understanding of discharge instructions typically requires a nursing assessment and explanation, more suitable for a licensed nurse.
B. Encouraging fluid intake might involve assessing the client's condition and providing specific advice, which aligns more with the responsibilities of a licensed nurse.
C. Measuring urinary output is a task that falls within the scope of practice for unlicensed assistive personnel (UAP), as it involves routine data collection and does not require clinical judgment.
D. Checking a client's femoral dressing after a cardiac catheterization requires observation for signs of bleeding, which involves assessment and potential interventions beyond the UAP's scope of practice.

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