Question

Which client would the nurse assess first?

a. male client with a hemoglobin of 15.9 g/dl
b. female client on warfarin with an international normalized ratio (inr) of 7.5
c. female client taking daily calcium supplements with a serum calcium level of 9.4 mg/dl
d. male client with a blood urea nitrogen (bun) of 20 mg/dl and a creatinine of 1.1mg/dl

Answer 1

The female client on warfarin with an INR of 7.5 should be assessed first due to the high risk of bleeding associated with an INR significantly above the normal therapeutic range. The other clients' lab values are within normal ranges, posing less immediate risk. so, option b is the correct answer.

Step-by-step explanation:

In assessing which client a nurse should examine first, priority is typically given to clients who exhibit signs or laboratory results that suggest a potential for immediate harm or life-threatening instability. Among the options provided, a female client on warfarin with an international normalized ratio (INR) of 7.5 warrants the most urgent assessment. A direct comparison with the other clients illustrates why:

1. A male client with a hemoglobin level of 15.9 g/dl, which is within the normal range, does not require immediate attention.
2. A female client taking daily calcium supplements with a serum calcium level of 9.4 mg/dl is also within the normal range for calcium homeostasis and would not be considered urgent.
3. A male client with blood urea nitrogen (BUN) of 20 mg/dl and a creatinine level of 1.1 mg/dl has values within the normal references for renal function, indicating no immediate concern.

On the other hand, the female client with an INR of 7.5 is significantly above the normal therapeutic range, suggesting a heightened risk of bleeding. Warfarin therapy usually aims for an INR between 2 and 3 for most indications; therefore, an INR of 7.5 could lead to severe complications and requires prompt assessment and intervention.