Question

A client is admitted with pancreatitis on the previous shift. The nurse evaluates the laboratory results. Which result requires immediate intervention by the nurse? A. Potassium \(4.0 \mathrm{mEq} / \mathrm{L}\) B. Sodium \(120 \mathrm{mEq} / \mathrm{L}\) C. Serum amylase 300 units/dL D. White blood cell \(12,000 \mathrm{cells} / \mathrm{mm}\)

Short answer

The laboratory result that requires immediate intervention is B. Sodium with a value of 120 mEq/L, as it indicates hyponatremia which can be life-threatening and cause severe neurological symptoms.

Step-by-step solution

Identify the normal reference range for each laboratory result

To determine which laboratory result is abnormal and requires immediate intervention, we should know the normal reference ranges for all the given parameters: - Potassium: \(3.5 - 5.0 \mathrm{mEq} / \mathrm{L}\) - Sodium: \(136 - 145 \mathrm{mEq} / \mathrm{L}\) - Serum amylase: \(25 - 125 \mathrm{units} / \mathrm{dL}\) - White blood cell count: \(4,000 - 11,000 \mathrm{cells} / \mathrm{mm^3}\)

Compare the given results to the normal reference ranges

We should compare the given lab results to the normal reference ranges identified in step 1: A. Potassium \(4.0 \mathrm{mEq} / \mathrm{L}\): Within the normal range (\(3.5 - 5.0 \mathrm{mEq} / \mathrm{L}\)). B. Sodium \(120 \mathrm{mEq} / \mathrm{L}\): Below the normal range (\(136 - 145 \mathrm{mEq} / \mathrm{L}\)). C. Serum amylase 300 units/dL: Above the normal range (\(25 - 125 \mathrm{units} / \mathrm{dL}\)). D. White blood cell \(12,000 \mathrm{cells} / \mathrm{mm^3}\): Above the normal range (\(4,000 - 11,000 \mathrm{cells} / \mathrm{mm^3}\)).

Determine the abnormal laboratory result that requires immediate intervention

Based on the comparison in step 2, we find that B, C, and D are abnormal. However, determining the one that requires immediate intervention, we can conclude as follows: - B, low sodium \(120 \mathrm{mEq} / \mathrm{L}\) (Hyponatremia): Hyponatremia can be life-threatening and cause severe neurological symptoms. Thus, it requires immediate intervention. - C, high serum amylase 300 units/dL: An elevated level of serum amylase is common in patients with pancreatitis. Although it is abnormal, it is not an immediate threat, and the nurse is already aware of the patient's pancreatitis diagnosis. - D, high white blood cell \(12,000 \mathrm{cells} / \mathrm{mm^3}\): An increased white blood cell count can be indicative of infection or inflammation. It is abnormal but does not require immediate intervention compared to hyponatremia.

Answer the exercise

Based on our analysis, the laboratory result that requires immediate intervention is B. Sodium \(120 \mathrm{mEq} / \mathrm{L}\).

Key concepts

Hyponatremia

Hyponatremia is a condition in which there is an abnormally low concentration of sodium in the blood. Sodium is essential for various body functions, including maintaining fluid balance, nerve function, and muscle contraction.

The normal serum sodium levels range from 136 to 145 milliequivalents per liter (mEq/L). When levels drop below 135 mEq/L, it is considered hyponatremia. Symptoms of hyponatremia can include headache, confusion, seizures, and in severe cases, coma. It is particularly concerning in acute conditions since rapid changes in sodium levels can lead to rapid onset of severe neurological symptoms.

Nursing intervention for hyponatremia involves careful monitoring of fluid intake and output, administering prescribed sodium supplements if necessary, and adjusting medications that may contribute to the condition. The nurse must also educate the patient on dietary sodium intake and recognize early signs of imbalance to prevent complications.

Laboratory Results Interpretation

Interpreting laboratory results is a critical skill for nurses and other healthcare providers. It involves comparing a patient's lab values with the normal reference ranges for healthy individuals. These reference ranges serve as a guide to identify deviations that may indicate a health issue.

As seen in the exercise provided, a nurse analyzes laboratory results to determine patient status and the priority of care. Some results, like an elevated serum amylase in the context of known pancreatitis, may be expected. However, abnormal values outside the context of the current medical diagnosis, such as severe hyponatremia, can indicate new and urgent problems.

Nurses should prioritize and communicate abnormal results that may require immediate medical intervention. For instance, in the given exercise, a sodium level of 120 mEq/L is a red flag that must be addressed promptly to prevent serious complications.

NCLEX-RN Exam Preparation

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) is a standardized exam that all nursing graduates must pass to become licensed. The exam tests the knowledge, skills, and abilities essential for the safe and effective practice of nursing at the entry level.

Preparing for the NCLEX-RN involves a thorough review of nursing content, practice with test questions, and familiarity with the exam format. Prioritizing concepts based on the likelihood of their appearance on the exam and their significance in clinical practice is key. This involves mastering topics like hyponatremia due to its potential severity.

Prospective test-takers should employ various study methods, including textbook reading, online courses, practice exams, and study groups. Understanding how to interpret laboratory results is another vital area, as it is frequently tested on the NCLEX-RN. Using questions similar to the provided exercise can be an effective study strategy, combining content review with practical application.