A nurse is reviewing laboratory data from a client who has pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?
Partial thromboplastin time (PTT) 55 seconds
Hematocrit 45%
White blood cell count 8,000/mm³
Platelets 74,000/mm³
The Correct Answer is D
A. Partial thromboplastin time (PTT) 55 seconds: This PTT value is within the therapeutic range for a client on heparin therapy.
B. Hematocrit 45%: This hematocrit value is within normal limits and is not concerning.
C. White blood cell count 8,000/mm³: A WBC count of 8,000/mm³ is within the normal range and does not require reporting.
D. Platelets 74,000/mm³: A low platelet count (thrombocytopenia) can indicate heparin-induced thrombocytopenia (HIT), a potentially serious complication of heparin therapy.
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Correct Answer is C
Explanation
A. 25 gtt/min: Calculating the correct rate reveals that this is not the correct answer.
B. 1500 gtt/min: This rate is too high; the calculation does not support this answer.
C. 50 gtt/min: To calculate: (100 mL / 120 min) × 30 gtt/mL = 50 gtt/min.
D. 83 gtt/min: This is too high based on the calculation.
Correct Answer is C
Explanation
A. Calcium 10 mg/dL: This calcium level is within the normal range (8.6-10.2 mg/dL) and does not require intervention.
B. Sodium 136 mEq/L: This sodium level is within the normal range (135-145 mEq/L).
C. Potassium 2.3 mEq/L: This potassium level is critically low; bumetanide is a loop diuretic that can cause hypokalemia, which can lead to dangerous cardiac dysrhythmias.
D. Magnesium 1.4 mEq/L: While slightly low, this magnesium level is only mildly decreased and not as immediately concerning as the potassium level.