Gastrointestinal System Disorders Q 261 - Gyan Darpan : Learning Portal
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Monday, 11 April 2022

Gastrointestinal System Disorders Q 261

Which of the following laboratory results would be expected in a client with peritonitis?
    A. Partial thromboplastin time above 100 seconds
    B. Hemoglobin level below 10 mg/dL
    C. Potassium level above 5.5 mEq/L
    D. White blood cell count above 15,000

Correct Answer: D. White blood cell count above 15,000

Because of infection, the client’s WBC count will be elevated. Peritoneal fluid (in patients with ascites or who are on PD) should be sent for cell count and differential, gram stain, and culture. In cirrhosis, a polymorphonuclear (PMN) count >250 cells/milliliter (mL) is diagnostic of SBP. In PD, a WBC count >100 cells/mL suggests peritonitis.

Option A: A PT time longer than 100 seconds may suggest disseminated intravascular coagulation, a serious complication of septic shock. Diagnosis of DIC involves a combination of laboratory tests and clinical evaluation. Laboratory findings suggestive of DIC include a low platelet count, elevated D-dimer concentration, decreased fibrinogen concentration, and prolongation of clotting times such as prothrombin time (PT).
Option B: A hemoglobin level below 10 mg/dl may occur from hemorrhage. Hemorrhage in trauma patients is associated with an early decrease in Hgb level. Hgb < or =10 gm/dL in the first 30 minutes of patient arrival will correctly identify presence or absence of significant bleeding in almost 9 of 10 trauma patients.
Option C: A potassium level above 5.5 mEq/L may indicate renal failure. When kidneys fail they can no longer remove excess potassium, so the level builds up in the body. High potassium in the blood is called hyperkalemia, which may occur in people with advanced stages of chronic kidney disease (CKD). Some of the effects of high potassium are nausea, weakness, numbness, and slow pulse.

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