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The nurse is caring for a client with massive gastrointestinal bleeding from a gastric ulcer who received 6 units packed red blood cells (PRBCs) and 2 units fresh frozen plasma (FFP). The most recent laboratory results are hemoglobin 8.0 g/dL (80 g/L), platelets 82,000/ mm? (82 X 109/L), prothrombin time (PT) 11.1 seconds, international normalized ratio (INR) 1.9, and partial thromboplastin time (PTT) 58 seconds. Vital signs are heart rate 110 beats/minute, respirations 24 breaths/minute, blood pressure 80/50 mm Hg, and oxygen saturation 94% on 4 liters oxygen via nasal canula. Which intervention should the nurse implement first? Reference Range: Hemoglobin [14 to 18 g/dL (140 to 180 g/L)] Platelets [150,000 to 400,000/mm3 (150 to 400 × 10°/L)] Prothrombin time (PT) [11.0 to 12.5 seconds] International Normalized Ratio (INR) [0.8 to 1.1] Partial Thromboplastin Time (PTT) [60 to 70 seconds] A Obtain a blood specimen for hematocrit. B Measure strict hourly urinary output. C Administer a PRN bolus normal saline. D Switch oxygen delivery to a face mask.
SCIENCE
HEALTH SCIENCE
NURSING

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