The nurse reviews the laboratory results for 4 assigned clients. Which result is most important for the nurse to report to the primary health care provider?

Question

Quizplus · Accepted Answer

The client with atrial fibrillation is at increased risk for the development of atrial thrombi due to blood stasis, which can embolize and lead to an ischemic brain attack. The INR (normal 0.75-1.25) is a measurement used to assess and monitor coagulation status in clients receiving anticoagulation therapy. The therapeutic INR level for a client receiving warfarin (Coumadin) to treat atrial fibrillation is 2-3. The subtherapeutic INR of 1.3 is the most important result to report to the health care provider (HCP) as the client is at increased risk for a stroke and dose adjustment is needed. (Option B) A client with chronic obstructive pulmonary disease and chronic bronchitis has chronic alveolar hypoxia, which stimulates erythropoiesis (red blood cell production) and leads to polycythemia (hematocrit >53% [0.53] in males, >46% [0.46] in females; hemoglobin >17.5 g/dL [175 g/L] in males, >16 g/dL [160 g/L] in females). Increased hematocrit and hemoglobin are expected in this client and are not the most important results to report to the HCP. (Option C) Leukocytosis (white blood cells >11,000/mm³ [11 × 10⁹/L]) is expected in a client with C difficile infection and is not the most important result to report to the HCP. (Option D) A client receiving gentamycin, a nephrotoxic drug, has a normal creatinine level (0.6-1.3 mg/dL [53-115 µmol/L), which is not the most important result to report to the HCP. Educational objective: The therapeutic INR range is 2-3 for a client receiving warfarin to treat atrial fibrillation. Subtherapeutic INR increases the risk for atrial thrombus formation, with subsequent embolization and stroke. Excess anticoagulation (INR >3-4) increases the risk for bleeding.

The Nurse Reviews the Laboratory Results for 4 Assigned Clients