The nurse is reviewing the laboratory test results for a client who has recently been diagnosed with hypertension. Which result is most important to communicate to the health care provider?
Serum creatinine of 2.8 mg/dL
Serum hemoglobin of 14.7 g/dL
Blood glucose level of 96 mg/dL
Serum potassium of 4.5 mEq/L
The Correct Answer is A
Among the given laboratory test results for a client with recently diagnosed hypertension, the most important result to communicate to the health care provider is option (A), "Serum creatinine of 2.8 mg/dL."
Serum creatinine is a measure of kidney function, and a value of 2.8 mg/dL indicates elevated creatinine levels. Elevated serum creatinine is a concerning finding, as it suggests decreased kidney function or kidney impairment. Hypertension can have a significant impact on the kidneys, and kidney damage is a common complication of uncontrolled high blood pressure.
The kidneys play a crucial role in regulating blood pressure by excreting waste products and excess fluids from the body. When kidney function is compromised due to hypertension, it can further worsen the blood pressure control, leading to a vicious cycle of kidney damage and worsening hypertension.
Option (B), "Serum hemoglobin of 14.7 g/dL," is within the normal range and does not indicate an immediate concern related to the client's hypertension.
Option (C), "Blood glucose level of 96 mg/dL," is also within the normal range for blood glucose and may not be directly related to the client's hypertension.
Option (D), "Serum potassium of 4.5 mEq/L," is within the normal range. While potassium levels are essential to monitor, they are not the most critical concern compared to kidney function in this context.
The elevated serum creatinine level suggests a potential complication of hypertension, namely kidney damage or decreased kidney function. Therefore, it is essential to communicate this finding promptly to the health care provider for further evaluation and appropriate management to address the client's kidney health and optimize blood pressure control.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The client taking isosorbide dinitrate/hydralazine (BiDil) and experiencing a headache should be assessed first. Isosorbide dinitrate/hydralazine is a medication combination used to treat heart failure, particularly in African American patients. However, one of the side effects of hydralazine is headaches.
Headache in a client taking this medication may indicate increased blood pressure as a compensatory response to vasodilation. If not addressed promptly, it may lead to worsening heart failure or other complications. Therefore, it is essential to assess the client's blood pressure, signs of worsening heart failure, and evaluate the severity and duration of the headache.
The other options may also require attention:
A) A client taking digoxin with a potassium level of 3.1 mEq/L needs assessment, as hypokalemia can increase the risk of digoxin toxicity. However, the headache in the BiDil client takes priority due to the potential complications related to increased blood pressure.
B) A client taking captopril and experiencing a frequent nonproductive cough may indicate a side effect of the medication. While it should be assessed, it is not as immediately concerning as the headache in the BiDil client.
C) A client taking carvedilol (Coreg) with a heart rate of 58 is within an acceptable range, especially if the client is tolerating it well without symptoms. It may not require immediate assessment unless there are other concerning symptoms.
Correct Answer is C
Explanation
The client's presentation of chest pain radiating to the left arm, sweating, shortness of breath, epigastric discomfort, cool and diaphoretic skin, tachycardia, and ST elevation on the electrocardiogram (ECG) are indicative of myocardial infarction (heart attack). These symptoms and findings are typical of acute coronary syndrome, specifically an ST-segment elevation myocardial infarction (STEMI).
Option A (Ischemic Stroke) is not the correct answer because the symptoms described in the client's presentation are primarily related to the cardiovascular system and not indicative of an ischemic stroke.
Option B (Chronic Stable Angina) is not the correct answer because chronic stable angina typically presents with chest pain on exertion or stress, and it usually subsides with rest or nitroglycerin. The client's symptoms of chest pain at rest, along with other findings, are more concerning for an acute cardiac event like a myocardial infarction.
Option D (Cardiogenic Shock) is a severe complication that can occur following a myocardial infarction, but the information provided in the scenario does not suggest that the client is in cardiogenic shock at this time. The client's blood pressure is not mentioned in the scenario, which is a crucial parameter to assess for cardiogenic shock.
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