Case Study Questions 59-63 The 58-year old client is admitted to the medical-surgical unit with complaints of abdominal pain, fatigue, dizziness, and bright red blood in the stool.  Morning labs: Time Lab Test Result Normal Range 0600 Red blood cell (RBC) 4.5/L 4.2-6.2/L White blood cell (WBC) 8,000mm3 5,000-10,000mm3 Platelets 180.000/L 150,000-400,000/L Hemoglobin 7.6g/dL 12-18g/dL Hematocrit 32% 37%-52% Occult blood Detected Negative Previous orders: Time Physician Order 0630 1 unit packed red blood cells with recheck of labs two hours after transfusion completion 0630 Bowel preparation (polyethylene glycol) 0630 Obtain consent for colonoscopy 0630 Pantoprazole 40mg IV Q8Hrs 0630 NPO 0630 Normal Saline IV at 125ml/hr continuous x 24 hours 0630 Hydromorphone 1mg IV push Q3Hrs PRN 0630 Insert foley catheter Question 63: The nurse reviews the afternoon labs as noted below.  Based on the new results, the nurse would update the plan of care with which of the following priorities? Select all that apply. Time Lab Test Result Normal Range 1400 Red blood cell (RBC) 4.2/L 4.2-6.2/L 1400 White blood cell (WBC) 8,000mm3 5,000-10,000mm3 1400 Platelets 180.000/L 150,000-400,000/L 1400 Hemoglobin 9.0g/dL 12-18g/dL 1400 Hematocrit 34% 37%-52%

Case Study Questions 59-63 The 58-year old client is admitted to the medical-surgical unit with complaints of abdominal pain, fatigue, dizziness, and bright red blood in the stool.  0600 lab values: Time Lab Test Result Normal Range 0600 Red blood cell (RBC) 4.5/L 4.2-6.2/L White blood cell (WBC) 8,000mm3 5,000-10,000mm3 Platelets 180.000/L 150,000-400,000/L Hemoglobin 7.6g/dL 12-18g/dL Hematocrit 32% 37%-52% Occult blood Detected Negative Question 61: Reviewing the same set of orders, which two orders should the nurse question?  Time Physician Order 0630 1 unit packed red blood cells with recheck of labs two hours after transfusion completion 0630 Bowel preparation (polyethylene glycol) 0630 Obtain consent for colonoscopy 0630 Pantoprazole 40mg IV Q8Hrs 0630 NPO 0630 Normal Saline IV at 125ml/hr continuous x 24 hours 0630 Hydromorphone 1mg IV push Q3Hrs PRN 0630 Insert foley catheter _______ _______

Smile, you did it!!! Check yes indicating you will hand in any scrap paper used. 

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