A doctor has planned hysterectomy surgery for a patient who is suffering from endometrial carcinoma. But when the lab report comes in which WBC value is 9800 cells/mm3. What would be priority intervention?

1. A

   Document the finding

2. B

   Inform to the surgeon

3. C

   Postponed OT

4. D

   Hyperpyrexia

Appeared in: PGIMER Sangrur NO - 2023

Explanation

• The patient's White Blood Cell (WBC) count of 9,800 cells/mm³ is within the standard normal range of 5,000 to 10,000 cells/mm³.
• For a normal and expected laboratory finding, the standard and priority nursing action is to accurately record the result in the patient's medical chart.
• This value indicates no acute infection or significant immunosuppression, meaning there is no immediate contraindication to the planned surgery based on this specific lab result.
• Actions like notifying the surgeon or postponing surgery are reserved for abnormal or critical values that pose a risk to the patient.

Why Other Options Were Wrong

• Option B: Informing the surgeon is not the priority for a normal lab value. This action creates unnecessary communication for a non-critical finding.
• Option C: Postponing the operation is a significant decision made based on abnormal findings that pose a direct threat to the patient's safety during surgery. A normal WBC count does not warrant this action.
• Option D: Hyperpyrexia is a medical term for an extremely high fever (a condition), not a nursing action or intervention. It is an illogical choice in the context of responding to a lab result.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Interpretation of preoperative laboratory values and corresponding nursing interventions helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• A fundamental nursing responsibility is the accurate interpretation of lab results and taking appropriate action. Knowing normal values prevents unnecessary alarms and ensures timely care.
• Failure to recognize an abnormal lab value can lead to serious patient harm, such as proceeding with surgery on an infected patient, leading to sepsis.
• What if the WBC count was 18,000 cells/mm³? In that case, the priority intervention would shift to immediately informing the surgeon, as this indicates a significant infection that would likely lead to the postponement of the surgery until the infection is treated.

How to Approach the Question

• First, identify the core clinical data provided in the question: the patient's WBC count is 9,800 cells/mm³.
• Next, recall or look up the normal reference range for a WBC count. The standard range is 5,000 to 10,000 cells/mm³.
• Compare the patient's value to the normal range. In this case, 9,800 falls within the normal range.
• Evaluate the options based on this finding. Since the value is normal, the appropriate action is routine documentation.
• Eliminate options that are indicated for abnormal findings (Inform surgeon, Postponed OT) or are irrelevant (Hyperpyrexia).

Concept Tested & Keywords

• Concept Tested: Interpretation of preoperative laboratory values and corresponding nursing interventions.
• Stem keywords: hysterectomy, endometrial carcinoma, WBC value, 9800 cells/mm3, priority intervention
• Lead-in keywords: priority intervention
• Clinical cues: The patient is preoperative for a hysterectomy.
• Clinical cues: The WBC count is 9800 cells/mm3, which is a key data point.

Question ID

QpeEZgNajk_ARq-Qr15tRI

Copy ID

Reference Book

E6 Nursing Fundamentals Taylor p. 178-180

E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 225-227