The nurse cares for a client who is a pale and reports frequent fatigue, weakness and dizziness. Which serum laboratory test result is the nurse’s priority for planning care?

RBCs 4.3mEq/L

Potassium 4.8 mEq/L

Hemoglobin of 9g/dl

Sodium 137 mEq/L

Answer and Explanation

The Correct Answer is C

A) RBCs 4.3 million/µL:
While a low RBC count can indicate anemia, the specific value provided here is not suggestive of anemia, and it does not explain the patient's symptoms of fatigue, weakness, and dizziness as clearly as a low hemoglobin would.

B) Potassium 4.8 mEq/L:
This result is not concerning and does not directly relate to the patient's reported symptoms of pallor, fatigue, and dizziness. Therefore, this lab result does not take priority in planning care at this time.

C) Hemoglobin of 9 g/dl:
This result is consistent with anemia, which is a likely cause of the patient’s symptoms of fatigue, weakness, dizziness, and pallor. Anemia can lead to decreased oxygen delivery to tissues, explaining the symptoms the patient is experiencing. The priority action for the nurse should be to address the underlying cause of anemia and manage it to improve the patient’s oxygenation and overall condition.

D) Sodium 137 mEq/L:
Although sodium imbalances can cause neurological symptoms such as confusion or lethargy, the patient’s reported symptoms of pallor, fatigue, and dizziness are more likely related to anemia. Sodium is not the most urgent concern for this patient at the moment.

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Correct Answer is B

Explanation

A. Impaired perineal skin integrity:
While impaired perineal skin integrity is a concern for clients with severe diarrhea, it is not the priority risk in this case. Diarrhea can lead to irritation and breakdown of the skin, especially in the perineal area, but this can generally be managed with proper skin care and barrier creams. While important, this is not the most critical issue at the moment.

B. Fluid and electrolyte imbalances:
The priority risk for a client with an acute exacerbation of Crohn's disease and severe diarrhea is fluid and electrolyte imbalances. Diarrhea causes significant fluid loss, which can lead to dehydration and imbalances in electrolytes such as sodium, potassium, and chloride. These imbalances can result in life-threatening complications like hypovolemic shock, arrhythmias, and kidney failure. Therefore, ensuring adequate fluid and electrolyte replacement is the top priority in this situation.

C. Pain related to abdominal cramping:
While pain due to abdominal cramping is common in Crohn's disease, it is not the most immediate risk in this scenario. Pain management is important for comfort, but the risk of dehydration, electrolyte imbalances, and potential shock due to fluid loss takes precedence. Pain relief can be addressed after managing the more critical issues.

D. Protein-calorie malnutrition:
Protein-calorie malnutrition is a concern for patients with Crohn's disease, especially with chronic disease or malabsorption. However, in the context of an acute exacerbation with severe diarrhea, the immediate concern is fluid and electrolyte imbalance. Nutritional concerns, including malnutrition, are important for long-term management, but the priority in this acute phase is stabilizing the client’s fluid status to prevent further complications.

A. Pernicious anemia B. Hemolytic anemia C. Iron deficiency anemia D. Aplastic anemia

Correct Answer is A

Explanation

A) Pernicious anemia:
Vitamin B12 injections are most commonly used to treat pernicious anemia, which is caused by a deficiency in vitamin B12 due to an inability to absorb the vitamin from the gastrointestinal tract. This condition is often associated with a lack of intrinsic factor, a protein required for vitamin B12 absorption. As a result, the body cannot make enough healthy red blood cells, leading to anemia. The treatment of pernicious anemia typically involves lifelong vitamin B12 injections, making this the correct answer.

B) Hemolytic anemia:
It is not typically treated with vitamin B12 injections. Instead, hemolytic anemia may require treatments that address the underlying cause of red blood cell destruction, such as corticosteroids, immunosuppressive therapy, or splenectomy, depending on the type of hemolysis. Therefore, vitamin B12 would not be the primary treatment for this type of anemia.

C) Iron deficiency anemia:
It is typically treated with iron supplements, either orally or intravenously, rather than vitamin B12. While both conditions cause anemia, the treatment for iron deficiency anemia is not vitamin B12, so this is not the correct choice.

D) Aplastic anemia:
This condition is usually treated with treatments such as bone marrow stimulants, blood transfusions, or bone marrow transplantation, rather than vitamin B12. Vitamin B12 supplementation would not be indicated for the treatment of aplastic anemia.

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The nurse cares for a client who is a pale and reports frequent fatigue, weakness and dizziness. Which serum laboratory test result is the nurse’s priority for planning care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who was admitted for an acute exacerbation of Crohn's Disease with severe diarrhea for the last two days. The nurse knows that which of the following is the priority risk for this client?

Correct Answer is B

Explanation

The nurse is preparing to administer a shot of vitamin B12 to a client with low hemoglobin. The nurse knows that this medication is most indicative of which type of anemia?

Correct Answer is A

Explanation

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