When caring for a client with pre-eclampsia, which laboratory result should the nurse report to the physician immediately?
Platelets 50,000/mm.
Hemoglobin 11 grams/dL.
Creatinine 0.3 mg/dL.
Fasting blood glucose 65 mg/dL.
The Correct Answer is A
Choice A rationale
A platelet count of 50,000/mm³ is critically low (normal range is 150,000-450,000/mm³) in a client with pre-eclampsia. Thrombocytopenia is a serious complication of pre-eclampsia and can significantly increase the risk of bleeding and hemorrhage. This finding requires immediate reporting and intervention.
Choice B rationale
A hemoglobin level of 11 grams/dL is within the lower end of the normal range for postpartum women (typically 12-15 g/dL) and is not an immediate concern in the context of pre-eclampsia, unless there is a rapid decline or other concerning symptoms.
Choice C rationale
A creatinine level of 0.3 mg/dL is below the normal range for non-pregnant adults (typically 0.6-1.2 mg/dL) and might be lower in pregnancy due to increased glomerular filtration rate. While kidney function should be monitored in pre-eclampsia, this specific value is not immediately alarming.
Choice D rationale
A fasting blood glucose of 65 mg/dL is within the normal range (typically 70-100 mg/dL) and is not a typical finding that requires immediate reporting in pre-eclampsia, although gestational diabetes can sometimes coexist.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A rationale
A glucose reading of 58 mg/dL in a newborn is below the normal range (typically 40-60 mg/dL in the first hours of life, rising to 50-90 mg/dL). While this requires intervention to prevent hypoglycemia, other parameters might indicate a more immediate threat to the newborn's well-being.
Choice B rationale
A temperature of 97.4°F (36.3°C) is below the normal range for a newborn (typically 97.7°F to 99.5°F or 36.5°C to 37.5°C). Hypothermia in a newborn can lead to cold stress, increasing oxygen and glucose consumption, potentially leading to respiratory distress and hypoglycemia. Therefore, a low temperature requires immediate assessment and intervention to warm the newborn.
Choice C rationale
A respiratory rate of 48 breaths/minute is within the normal range for a newborn (typically 30-60 breaths/minute). While the respiratory rate should be monitored, it does not indicate an immediate critical issue in this case.
Choice D rationale
A pulse of 134 beats/minute is within the normal range for a newborn (typically 110-160 beats/minute). While the heart rate should be monitored, it does not indicate an immediate critical issue in this case. .
Correct Answer is D
Explanation
Choice A rationale
Rapid plasma regain is not a standard laboratory test associated with hyperemesis gravidarum. Hyperemesis gravidarum is characterized by severe nausea and vomiting leading to dehydration and electrolyte imbalances.
Choice B rationale
A urine culture is used to detect urinary tract infections, which are not a primary concern in hyperemesis gravidarum unless specifically indicated by symptoms of a UTI.
Choice C rationale
Prothrombin time (PT) and other coagulation studies assess blood clotting. While severe dehydration and malnutrition from hyperemesis gravidarum could theoretically affect coagulation, it is not a routine initial test to anticipate.
Choice D rationale
Urine ketones are a key laboratory finding in hyperemesis gravidarum. Due to persistent vomiting and inadequate oral intake, the body starts to break down fat for energy, leading to ketonuria. The presence of ketones in the urine indicates starvation and the need for intravenous fluids and nutritional support.
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