Which data is cause for immediate intervention for a client after a right shoulder replacement?
Creatinine level is 0.8 mg/dL.
Potassium level is 4.2 mEq/L.
White blood cell count is 9,000 mm³.
Hemoglobin is 7.1 g/dL.
The Correct Answer is D
Choice A Reason
A creatinine level of 0.8 mg/dL falls within the normal range for adults, which is typically 0.6 to 1.2 mg/dL for males and 0.5 to 1.1 mg/dL for females. This indicates normal kidney function and is not a cause for immediate intervention post-operatively.
Choice B Reason
A potassium level of 4.2 mEq/L is within the normal range, which is generally between 3.6 and 5.2 mEq/L. This level indicates a stable electrolyte balance and is not a cause for immediate concern following shoulder replacement surgery.
Choice C Reason
A white blood cell (WBC) count of 9,000 mm³ is within the normal range, which typically spans from 4,500 to 11,000 WBCs per mm³. This suggests there is no active infection or inflammation that requires immediate intervention.
Choice D Reason
A hemoglobin level of 7.1 g/dL is considered low, as the normal range for adult males is generally 13.8 to 17.2 g/dL and for adult females is 12.1 to 15.1 g/dL. Low hemoglobin can indicate anemia, which may be due to blood loss during surgery or other underlying conditions. This requires immediate intervention to address potential oxygenation issues and determine the cause of the anemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice a reason:
A history of allergy to iodine is a critical finding to report before a coronary angiography because the contrast dye used in the procedure typically contains iodine. Patients with an iodine allergy may experience severe reactions, including anaphylaxis, which can be life-threatening. Precautions such as premedication with steroids and antihistamines or the use of alternative contrast agents may be necessary.
Choice b reason:
A serum potassium level of 4.0 mEq/L is within the normal range, which is approximately 3.5 to 5.2 mEq/L for adults. Therefore, this finding is not significant and does not need to be reported to the healthcare provider prior to the procedure.
Choice c reason:
A blood pressure reading of 138/90 mmHg is slightly elevated but does not reach the threshold for stage 1 hypertension, which starts at 140/90 mmHg for individuals under 60 years of age. While it should be monitored, it is not an urgent concern that needs to be reported immediately before a coronary angiography unless the patient shows symptoms of hypertensive crisis.
Choice d reason:
An EKG showing atrial fibrillation is an important finding; however, it is not typically a contraindication for coronary angiography unless the patient is hemodynamically unstable or symptomatic. Atrial fibrillation can increase the risk of stroke, but anticoagulation management is usually the focus rather than postponing necessary diagnostic procedures.
Correct Answer is D
Explanation
Choice a reason:
Warming the hands with water before testing is actually a recommended practice. It helps increase blood flow to the fingertips, making it easier to get a sufficient blood sample for testing. Cold hands can restrict blood flow, leading to difficulty in obtaining a blood sample and potentially inaccurate results.
Choice b reason:
Alternating fingers for blood glucose testing is also a recommended practice. It helps prevent soreness and calluses on the fingers from repeated pricks. Using different fingers or different sides of the same finger can help reduce pain and potential damage to the skin.
Choice c reason:
Choosing the center of the finger pad as a puncture site is not recommended. The sides of the fingertips are preferred because they have fewer nerve endings, making the process less painful. The center of the finger pad has a denser nerve supply and can lead to more discomfort during the test.
Choice d reason:
A random blood glucose result of 115 mg/dL is slightly above the normal range for non-diabetics, which is typically between 70 to 99 mg/dL when fasting. For someone with diabetes, this result might be considered within a target range, depending on individual treatment goals set by healthcare providers. However, it's important to note that a single glucose reading does not provide a complete picture of glucose control. An A1C test, which reflects average blood glucose levels over the past 2-3 months, is also necessary to assess overall glucose management.
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