51. A client is admitted for a cholecystectomy because of cholelithiasis. A nurse notes that the serum amylase report shows a level of 900 units/L. Which action should the RN take?
51. A client is admitted for a cholecystectomy because of cholelithiasis. A nurse notes that the serum amylase report shows a level of 900 units/L. Which action should the RN take?
. Prepare the client for surgery.
. Assess the client for jaundice.
. Check the RBC, Hgb, and Hct reports.
. Call and report the findings to the physician.
Test-Taking Tip
By knowing the normal laboratory values, you can see that there is a problem that must be reported. Know the significance of an elevated serum amylase: Answers 1, 2, and 3 have no relevance to this abnormal laboratory result. If unsure, remember that the serum bilirubin reflects jaundice (Answer 2), and the RBC count would reflect anemia (Answer 3), leaving the decision to postpone surgery as the only option.
Content Area: Adult Health, Gastrointestinal; Integrated Process: Nursing Process, Analysis; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Laboratory Values
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Answer 1 is incorrect because this client has a possible inflammatory process due to obstruction of the pancreatic duct by a gallstone. Surgery should be postponed until further evaluation by the physician. Answer 2 is incorrect because an elevated serum amylase does not reflect obstructive jaundice. Answer 3 is incorrect because the white blood cell (WBC) count, not the red blood cell (RBC) count, would be elevated in acute pancreatitis. The hemoglobin and hematocrit will be altered later from decreased transferrin and changes in iron absorption. Answer 4 is correct because cholelithiasis may block the pancreatic duct and initiate pancreatitis. The elevated serum amylase report indicates that the client has pancreatitis and the operation should be canceled because of the acute inflammatory process.