CORRECT ANSWER:

B) Hgb 6.8

MORE INFO:

• B) Hgb 6.8. Often packed red blood cells need to be given in patients who have hgb <7.
  • It’s important to take every situation case by case but this is the standard.
  • It’s always important to look at their baseline if available.
  • Some drop in hemoglobin post op is expected, but <7 is very low and often necessitates blood transfusion. .
  • If there are concerns of active ongoing bleeding a blood transfusion may be given at an even higher hemoglobin level.
  • Because this patient just had a surgery blood loss is the major concern.
  • Remember there are some conditions where hemoglobin is chronically low (ex: sickle cell anemia, renal disease) this is why baseline comparison and trending h & h are so important

OTHER ANSWERS:

• A) WBC 13: It is normal to sometimes see some elevation in WBC post op.
  • This is very common to see and doesn’t always indicate infection.
  • Trending the WBC would be the important thing to do in addition to watching for fever and surgical site appearance, etc.. .
• C) Na 129. Normal sodium 135-145.
  • This is not critically low but Na should be monitored to make sure no further drops
• D) K 2.9
  • Potassium would definitely need to be replaced soon especially to avoid any type of arrhythmia.
  • But the hemoglobin would be the most important to address first -major concerns blood loss, continued bleeding Follow trends on this, monitor for fever, sepsis indicators, and surgical sites

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