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    HESI RN Pharmacology 106a Proctored Exam

    The nurse is administering SUBQ enoxaparin to a client following knee replacement surgery to prevent a deep vein thrombosis. Which laboratory result requires immediate action by the nurse?Reference Range:Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]Platelets [150,000 to 400,000/mm³ (150 to 400 x 10⁹/L)]Creatinine [0.5 to 1.1 mg/dL (44 to 97 umol/L)]Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

    Explanation & Rationale

    Choice A reason: A platelet count of 100,000/mm³ is significantly below the normal range and indicates thrombocytopenia, which increases the risk of bleeding. Enoxaparin, an anticoagulant, further elevates this risk, making immediate intervention necessary. The nurse must notify the healthcare provider and take appropriate measures to prevent potential bleeding complications.Choice B reason: A blood urea nitrogen (BUN) level of 20 mg/dL is at the upper limit of the normal range and does not require immediate action. This value does not indicate a critical change in the client's condition and does not have the same urgency as a low platelet count.Choice C reason: A serum creatinine level of 1.0 mg/dL is within the normal range and does not require urgent action. This result does not suggest any immediate threat to the client's health and is not influenced by the administration of enoxaparin.Choice D reason: A hematocrit level of 45% is within the normal range and does not require immediate intervention. This value does not indicate any abnormality that would necessitate urgent action by the nurse.

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