The nurse is reviewing the postsurgical laboratory values of an ...

[mwit1967]

The nurse is reviewing the postsurgical laboratory values of an older adult client. The client's erythrocyte sedimentation rate (ESR) is 20 mm/hr. The nurse initially responds to this data by:
 
  a. asking the client if he or she has been di-agnosed with any chronic inflammatory diseases.
  b. recognizing that the value is normal for older adults.
  c. notifying the client's health care provider immediately.
  d. requesting that the laboratory rerun the test.

Question 2

When asked by an older adult client, What is the difference between my normal laboratory val-ues and the ones for a 55-year-old? The nurse responds based on the understanding that there are:
 
  a. age-adjusted ranges for older adults for all of the common laboratory findings, similar to those for infants and children.
  b. no age-adjusted ranges for older adults due to the large variations within the age group and the increasing number of fac-tors that influence the results.
  c. age-adjusted ranges only for the over-85 age group; there are no expected changes in the 65- to 84-year-old age group.
  d. age-adjusted ranges only for the hemato-logical tests, which are due mostly to changes in the bone marrow.

[ebenov]

Answer to Question 1

ANS: B
The ESR can be slightly elevated (10-20 mm/hr) in healthy older adults, especially those with a chronic disease that results in inflammation. Asking the client if he or she has such a diagnosis is not the initial response. This slight elevation does not warrant immediate notification or rerunning of the test.

Answer to Question 2

ANS: B
There are no age-adjusted ranges for laboratory values due to the variation within the group, as well as the many chronic illnesses of older adults. The older one is, the more likely variations are to be seen. Although several age-related hematological changes occur, mainly from changes in the bone marrow, few are clinically significant.