The nurse is reviewing the laboratory values of a patient scheduled for surgery. Which one of the following results is unfavourable?

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

A hemoglobin (Hb) level of 8 gm% indicates moderate anemia, as the normal range is typically 12–16 g/dL for females and 14–16 g/dL for males.
Anemia reduces the blood's oxygen-carrying capacity, which is crucial for tolerating the physiological stress of surgery and anesthesia.
This low level significantly increases the risk of perioperative complications, including tissue hypoxia, impaired wound healing, and cardiac strain.
According to clinical guidelines, elective surgery is often deferred in patients with significant anemia to allow for investigation and treatment, with a common preoperative target being a hemoglobin level above 10 g/dL.

Option A: A Fasting Blood Sugar (FBS) of 84 mg% is a normal and favorable result. The typical normal range is 74–106 mg/dL.
Option C: A serum creatinine of 0.7 mg/dl is a normal result, indicating proper kidney function. The normal range is approximately 0.6–1.2 mg/dL.
Option D: A blood urea level of 28 mg/dl is considered within the acceptable range (approx. 20-40 mg/dL) and does not pose a significant surgical risk, especially when serum creatinine is normal.

Clinical Relevance

Nursing practice connection: Use the key finding related to Preoperative assessment and interpretation of laboratory results to guide bedside assessment, documentation, and the next nursing action.
A primary nursing responsibility in perioperative care is to review, recognize, and report critical laboratory values to the surgical and anesthesia teams. Prompt communication about a low hemoglobin level is essential for patient safety.
Preoperative anemia is linked to increased morbidity, mortality, and a higher likelihood of requiring blood transfusions, which have their own associated risks.
What if? If the surgery were an emergency (e.g., trauma with active bleeding), an Hb of 8 gm% would still be a major concern, but the procedure would likely proceed with simultaneous blood transfusion, as the risk of delaying surgery would outweigh the risk of anemia.

How to Approach the Question

First, identify the core task of the question: to find the 'unfavourable' lab result in the context of a patient 'scheduled for surgery'.
Next, recall the normal reference ranges for the four laboratory tests provided: Fasting Blood Sugar (FBS), Hemoglobin (Hb), Serum Creatinine, and Blood Urea.
Systematically compare each option's value against its normal range.
Evaluate FBS 84 mg/dL: This is within the normal range (approx. 70-100 mg/dL).
Evaluate Hb 8 gm%: This is significantly below the normal range (approx. 12-16 g/dL), indicating anemia.
Evaluate Serum-creatinine 0.7 mg/dl: This is within the normal range (approx. 0.6-1.2 mg/dL).

Concept Tested & Keywords

Concept Tested: Preoperative assessment and interpretation of laboratory results.
Stem keywords: laboratory values, patient scheduled for surgery, unfavourable
Lead-in keywords: Which one
Clinical cues: The context 'scheduled for surgery' is critical as it sets the standard for acceptable versus unfavorable lab results, focusing on perioperative risk.
Negative lead-in flag: false

QTiXzqi0my_VfXW5n0n0eH

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 178-180

E6 Gynecology Williams p. 412-414

Practise the full SCTIMST Staff Nurse - 2015 (Set-A)

Attempt every question from this paper in a timed mock, then review the full solution for each one.