The nurse conducts a physical assessment for a client with severe right lower quadrant (RLQ) abdominal pain. The nurse notes that the abdomen is rigid and the client's temperature is 101.1° F (38.4° C)
Which laboratory value does the nurse bring to the attention of the health care pro-vider as a priority? a. A "left shift" in the white blood cell count
b. White blood cell count, 22,000/mm3
c. Serum sodium, 149 mEq/L
d. Serum creatinine, 0.7 mg/dL
B
This client may have appendicitis based on RLQ pain. A white blood cell count of 22,000/mm3 is severely elevated and could indicate a perforated appendix, as could the fever. The nurse should bring these findings to the provider's attention as soon as possible. A left shift would be expected in uncomplicated appendicitis. The sodium reading is only slightly high; this could be due to hemoconcentration from vomiting or from decreased intake. The creatinine level is normal.
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