A client is scheduled for a total gastrectomy for gastric cancer. ...

[tfester]

A client is scheduled for a total gastrectomy for gastric cancer. What preoperative laboratory result should the nurse report to the surgeon immediately?
 
  a. Albumin: 2.1 g/dL
  b. Hematocrit: 28
  c. Hemoglobin: 8.1 mg/dL
  d. International normalized ratio (INR): 4.2

Question 2

A client had an upper gastrointestinal hemorrhage and now has a nasogastric (NG) tube. What comfort measure may the nurse delegate to the unlicensed assistive personnel (UAP)?
 
  a. Lavaging the tube with ice water
  b. Performing frequent oral care
  c. Re-positioning the tube every 4 hours
  d. Taking and recording vital signs

[batool]

Answer to Question 1

ANS: D
An INR as high as 4.2 poses a serious risk of bleeding during the operation and should be reported. The albumin is low and is an expected finding. The hematocrit and hemoglobin are also low, but this is expected in gastric cancer.

Answer to Question 2

ANS: B
Clients with NG tubes need frequent oral care both for comfort and to prevent infection. Lavaging the tube is done by the nurse. Re-positioning the tube, if needed, is also done by the nurse. The UAP can take vital signs, but this is not a comfort measure.