The nurse assessing the 4-month-old brought to the emergency room for poor feeding and signs of dehydration notes the infant seems to be looking down and sclera is visible superior to the iris. The nurse reports this assessment to the provider and receives orders for care. Which order does the nurse question? 

The patient is admitted to the hospital after fainting at home. Blood tests reveal a hypochromic, microcytic anemia with a large amount of fetal hemoglobin. Thrombocytopenia is noted as well. The lymph nodes, spleen, and liver are all within normal limits for size and consistency. A blood transfusion and platelet transfusion are administered, with less than expected results. The nurse anticipates administering antithymocyte globulin in response to which result?   

The 18-year-old patient in sickle cell crisis has received multiple blood transfusions. During the shift assessment, the nurse notes the patient’s heart rate is 132 bpm, blood pressure is 102/58 mmHg, and the sclera are yellow. Which lab result would be surprising for this patient?