The evening shift nurse reviews the preoperative checklist and latest serum laboratory values for an elderly client with a ruptured diverticulum who is scheduled for surgery in the early morning. Which laboratory value is most important for the nurse to report to the health care provider?

Question

Quizplus · Accepted Answer

Creatinine level of 2.5 mg/dL (221 µmol/L) is the most important abnormal value (normal 0.6-1.3 mg/dL [53-115 µmol/L]) for the nurse to report to the health care provider. An elevated creatinine level increases the risk for intra- and postoperative complications. Nothing-by-mouth (NPO) status preoperatively, dehydration (ie, fluid shift from peritonitis), intraoperative fluid losses, antibiotic therapy, and advanced age affect renal function and increase the risk for postoperative exacerbation of kidney injury in this client. (Option B) Potassium level 3.5 mEq/L (3.5 mmol/L) is within normal limits (3.5-5.0 mEq/L [3.5-5.0 mmol/L]). (Option C) Sodium level 134 mEq/L (134 mmol/L) is decreased (normal 135-145 mEq/L [135-145 mmol/L]) but is most likely related to NPO status and fluid shift from peritonitis. (Option D) Elevated White blood cell count (normal 4,000-11,000/mm³ [4.0-11.0 ×10⁹/L]) is an expected finding related to ruptured diverticulum and peritonitis. Educational objective: NPO status preoperatively, dehydration, intraoperative fluid losses, antibiotic therapy, and advanced age can negatively affect renal function. An elevated serum creatinine level preoperatively increases the risk for postoperative kidney injury.

The Evening Shift Nurse Reviews the Preoperative Checklist and Latest