A nurse is caring for a client who has human immunodeficiency virus (HIV). Which laboratory value should the nurse alert the provider of?
Positive Western blot test
CD4-T-cell count 180 cells/mm³ (Range: 500 to 1500 cells/mm³)
Platelets 150,000/mm³ (Range: 150,000-400,000 cells/mm³)
WBC 5,000/mm³ (Range: 5,000-10,000 cells/mm³)
The Correct Answer is B
A. A positive Western blot test indicates an HIV diagnosis, which is expected in a client with HIV and does not require urgent intervention.
B. A CD4-T-cell count of 180 cells/mm³ is significantly low (normal range: 500 to 1500 cells/mm³) and indicates severe immunosuppression, putting the client at increased risk for opportunistic infections, warranting immediate attention from the provider.
C. A platelet count of 150,000/mm³ is at the lower end of the normal range and does not typically require immediate intervention unless there are clinical symptoms associated.
D. A WBC count of 5,000/mm³ is within the normal range and does not indicate a need for urgent intervention.
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Correct Answer is D
Explanation
A. Milk and cheese are low in iron content and are not recommended for increasing iron levels in clients with iron-deficiency anemia.
B. Whole grain breads may contain some iron but are not as high in iron as other food sources.
C. Fresh fruits do not provide significant amounts of iron and are not a good source for addressing iron deficiency.
D. Red meat and organ meat are excellent sources of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant sources, making them the best choice for increasing iron intake in clients with iron-deficiency anemia.
Correct Answer is A
Explanation
A. Sharp pain in the lower back is a classic symptom of an acute hemolytic reaction, which can occur due to incompatible blood transfusions.
B. Coughing more could indicate a transfusion-related acute lung injury (TRALI) but is not a typical sign of an acute hemolytic reaction.
C. Ringing in the ears can occur with other conditions but is not a common sign of an acute hemolytic reaction.
D. Feeling needles poking in the feet is vague and not specifically associated with acute hemolytic reactions, which are characterized by more severe systemic symptoms.