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Exhibits

Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.

Coagulation studies

Type and screen

Urine osmolality

Complete blood count

Blood culture

Lipid panel

Arterial blood gas

Electrolytes

Answer and Explanation

Correct Answer : A,B,D,G,H

A. Coagulation Studies: This client has liver and spleen lacerations with blood noted in the peritoneum, increasing the risk of coagulopathy due to active bleeding. The liver is responsible for producing clotting factors, and an injury may impair coagulation. The client also has a low hemoglobin (9.3 g/dL) and hematocrit (30%), suggesting ongoing blood loss. Monitoring prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) can guide transfusion therapy (e.g., fresh frozen plasma or platelets).
B. Type and Screen: This client has evidence of hemorrhagic shock (tachycardia, narrow pulse pressure, low hemoglobin/hematocrit) and may require blood transfusion. Type and screen determines ABO blood type and Rh factor to ensure availability of compatible blood products. If bleeding worsens, crossmatching blood would be necessary for transfusion.
C. Urine osmolality: Not a priority in this trauma case. Urine osmolality assesses kidney function and hydration status but does not provide urgent information about blood loss, shock, or ventilation status.
D. Complete Blood Count (CBC): Provides serial hemoglobin and hematocrit (H&H) monitoring to assess for ongoing internal bleeding. White blood cell (WBC) count helps detect infection or inflammation post-operatively. Platelets are critical for clotting and must be monitored, especially in trauma patients at risk for coagulopathy.
E. Blood culture: Used to detect bloodstream infections (sepsis), which is not an immediate concern in this trauma patient. While infection risk is relevant postoperatively, it is not a priority test for acute trauma care.
F. Lipid panel: Lipid panels evaluate cholesterol and triglyceride levels, which are irrelevant in acute trauma management.
G. Arterial Blood Gas (ABG): This client is intubated and ventilated, making ABG analysis essential for evaluating: Oxygenation (PaO₂, SaO₂) and ventilation (PaCO₂), Acid-base balance (pH, bicarbonate levels). Early detection of metabolic acidosis, which may indicate shock or inadequate perfusion.
H. Electrolytes: Trauma and fluid resuscitation can cause electrolyte imbalances, leading to cardiac arrhythmias, fluid shifts, and metabolic disturbances. Potassium (K⁺) is Essential to monitor due to IV fluids with potassium chloride infusion. Sodium (Na⁺), chloride (Cl⁻), and bicarbonate (HCO₃⁻) are crucial in assessing fluid status and acid-base balance. Lactate levels (part of a metabolic panel) can indicate tissue hypoxia and worsening shock.

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Correct Answer is A

Explanation

A: Controlling blood pressure to less than 140/80 mm Hg is essential for reducing the risk of diabetic retinopathy, which can contribute to blurred vision and other complications.

B: Educating the family about the disease is important, but it does not directly address the client’s blurred vision or its underlying cause.

C: While eye care is important, this outcome does not focus on addressing the underlying issue of blurred vision in a client with diabetes.

D: Although acceptance of health status is important, it is not as directly related to managing the client’s vision issues as controlling blood pressure.

A. Blood pressure. B. Apical heart Fate. C. Pulse pressure. D. Level of consciousness.

Correct Answer is A

Explanation

A. Blood pressure. The nurse should assess the client’s blood pressure both while lying down and standing to check for any signs of orthostatic hypotension, which is a drop in blood pressure upon standing.

B. Apical heart rate. While heart rate is important, it is not directly related to the side effect of orthostatic hypotension.

C. Pulse pressure. Pulse pressure (the difference between systolic and diastolic blood pressure) is not the primary assessment when checking for orthostatic hypotension.

D. Level of consciousness. Although important for overall assessment, the primary focus for orthostatic hypotension is blood pressure.

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Exhibits Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.

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Exhibits

Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.