Week 3- Lab Values
A client is brought to the emergency department states that he has accidentally been taking two times his prescribed dose of Warfarin (Coumadin). After observing that the client has no evidence of any obvious bleeding, the nurse should do which of the following? A. Draw a sample for activated partial thromboplastin time (aPTT) level. B. Draw a sample for prothrombin time (PT) level and international normalized ratio (INR). C. Prepare to administer Vitamin K. D. Prepare to administer Protamine sulfate.
B. Draw a sample for prothrombin time (PT) level and international normalized ratio (INR). Rationale: The next action for the nurse to take is to draw a sample for INR and PT level to check the client's anticoagulation status and risk for bleeding. These results will provide information on how to manage the client either giving an antidote such as Vitamin K or administering a blood transfusion. A: The aPTT determines the effects of heparin therapy. C: The results of the INR and PT level will be needed first. D: Protamine sulfate is the antidote for heparin overdose.
A nurse is reviewing the complete blood count (CBC) of an adult who has been diagnosed with idiopathic thrombocytopenic purpura (ITP). Which of the following laboratory result should the nurse report immediately to the physician? A. Platelet count of 54,000/mm3. B. Hemoglobin level of 7.1 g/dL. C. Reticulocyte count of 6.5%. D. Eosinophil count of 700 cells/mm3.
B. Hemoglobin level of 7.1 g/dL. Rationale: The low hemoglobin level indicates that the patient has an active bleed, and immediate actions such as additional diagnostic exam and blood transfusions can be suggested. Options A, C, and D: Decreased platelet count, increased reticulocyte and increased eosinophil count are expected in a patient with idiopathic thrombocytopenic purpura (ITP).
The laboratory values of an adult male client reveal the presence of hepatitis B surface antigens and hepatitis B antibodies. Which of the following laboratory results should the nurse also expect to see? Select all that apply. A. Elevated serum albumin B. Low serum globulin C. Elevated serum transaminate (ALT and AST) D. Prolonged prothrombin time (PT) E. Low urine bilirubin
C. Elevated serum transaminate (ALT and AST) D. Prolonged prothrombin time (PT) Rationale: (1) In viral hepatitis, serum albumin levels are low. (2) In viral hepatitis, serum globulin levels are high. (3) CORRECT: In viral hepatitis, serum transaminate levels are elevated. (4) CORRECT: In viral hepatitis, prothrombin time is prolonged. (5) In viral hepatitis, urine bilirubin levels are elevated.
What does Hematocrit measure? A. Oxygen carrying pigment in blood B. Measure of the WBC in total blood volume C. Measure of the percentage of RBC in total blood volume (cell volume) D. Concentration
C. Measure of the percentage of RBC in total blood volume (cell volume) The percentage of RBCs in the blood determines the bloods viscosity
A male client with atrial fibrillation who is receiving maintenance therapy of warfarin (Coumadin) has a prothrombin time of 37 seconds. Based on the result, the nurse will follow which of the following doctor's order? A. Administering the next dose of the warfarin. B. Increasing the next dose of warfarin. C. Decreasing the next dose of warfarin. D. Withholding the next dose of warfarin.
D. Withholding the next dose of warfarin. Rationale: The normal prothrombin time is 9.6 to 11.8 seconds (male adult). A therapeutic level PT level is 1.5 to 2 times higher than the normal level. Since the value of 37 seconds is high, the nurse should expect that the client next dose of warfarin will be withheld.
