Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

What is the primary nursing concern for the patient with persistently low Hgb levels?

1. Monitor for signs of dehydration

2. Assess for potential bleeding

3. Evaluate electrolyte balance

4. Ensure adequate oxygen delivery

The correct answer is: Assess for potential bleeding

The primary nursing concern for a patient with persistently low hemoglobin (Hgb) levels is to assess for potential bleeding. Hemoglobin levels are indicative of the oxygen-carrying capacity of the blood, and low levels can suggest significant health issues, including acute or chronic blood loss. Identifying the source of potential bleeding is crucial, as it can lead to anemia and compromised perfusion if not addressed. Nurses should perform thorough assessments to determine if there are signs of hemorrhage, such as hypotension, tachycardia, or decreased urine output. Additionally, a careful review of the patient's history and physical examination will help in identifying any possible bleeding sources, whether internal (such as gastrointestinal bleeding) or external. This proactive assessment is vital in implementing timely interventions, like fluid resuscitation or blood transfusion, to stabilize the patient and improve clinical outcomes. Monitoring for dehydration, evaluating electrolyte balance, and ensuring adequate oxygen delivery are all important aspects of nursing care, but they are secondary to identifying potential bleeding in the context of low Hgb levels. If bleeding is present, it directly affects oxygen delivery and could exacerbate fluid or electrolyte imbalances. Thus, addressing potential bleeding is the most immediate and critical concern for patient safety and recovery.