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Zorluk: OrtaReduction of Risk Potential

A practical nurse (PN) is reviewing the morning laboratory results for several assigned clients on a medical-surgical unit. Which of the following laboratory findings indicate an immediate risk for complications and should be reported to the registered nurse (RN) without delay? Select all that apply.

  1. A client receiving oral furosemide who has a serum potassium level of 2.8 mEq/L.Cevap
  2. B
    A client diagnosed with chronic kidney disease who has a blood urea nitrogen (BUN) of 32 mg/dL.
  3. A client prescribed warfarin for atrial fibrillation who has an International Normalized Ratio (INR) of 5.5.Cevap
  4. D
    A client recovering from pneumonia who has a white blood cell (WBC) count of 12,000/mm³.
  5. A client receiving a continuous heparin infusion who has a platelet count of 75,000/mm³.Cevap
  6. F
    A client with type 2 diabetes mellitus who has a glycosylated hemoglobin (HbA1c) of 7.2%.

Cevap

The correct options are the client with a potassium level of 2.8 mEq/L, the client with an INR of 5.5, and the client with a platelet count of 75,000/mm³.
The correct options represent critical laboratory values that place the clients at immediate risk for severe, life-threatening complications. A potassium level of 2.8 mEq/L is critically low and can cause fatal cardiac dysrhythmias. An INR of 5.5 is significantly supratherapeutic and places the client at high risk for spontaneous hemorrhage. A platelet count of 75,000/mm³ in a client on a heparin infusion indicates severe thrombocytopenia and raises suspicion for heparin-induced thrombocytopenia (HIT), a dangerous complication requiring immediate intervention.

Adım Adım Çözüm

1
Evaluate the serum potassium level of the client taking furosemide.
The value of 2.8 mEq/L is identified as critically low.
Furosemide is a potassium-wasting diuretic, and severe hypokalemia can lead to life-threatening cardiac dysrhythmias, making this an immediate priority.
2
Analyze the BUN, WBC count, and HbA1c results.
These values are abnormal but expected based on the clients' respective diagnoses (chronic kidney disease, pneumonia, and diabetes).
Expected abnormal findings in chronic or resolving conditions do not require immediate emergency escalation to the RN.
3
Assess the INR and platelet count for the clients receiving anticoagulants.
The INR of 5.5 is significantly above the therapeutic range, and the platelets of 75,000/mm³ indicate severe thrombocytopenia.
Both of these findings pose a high, immediate risk for hemorrhage or heparin-induced complications, requiring urgent notification.

Anahtar Kavram

Evaluating laboratory values to identify acute, life-threatening complications requiring immediate escalation versus expected baseline abnormalities.
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Konular

Reduction of Risk Potential

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