The nurse is caring for an older adult patient with a decrease in kidney function. Which of the following laboratory values should the nurse monitor?
Complete Blood Count
Creatinine
Serum Sodium and Potassium
Serum Albumin
The Correct Answer is B
A. Complete Blood Count: A CBC evaluates red and white blood cells and platelets, which are not direct indicators of kidney function. While anemia can develop in chronic kidney disease, CBC changes are secondary and do not provide immediate information about renal clearance.
B. Creatinine: Serum creatinine is a primary marker of kidney function because it reflects the kidneys’ ability to filter waste products. Elevated levels indicate impaired glomerular filtration rate (GFR) and help guide medication dosing and fluid management in older adults.
C. Serum Sodium and Potassium: Electrolytes can be affected by kidney impairment, but changes often occur after kidney function declines significantly. While important to monitor for complications such as hyperkalemia or hyponatremia, these values are not as sensitive as creatinine for detecting early decreases in renal function.
D. Serum Albumin: Albumin measures protein status and nutritional health rather than kidney filtration ability. Low levels may be seen in nephrotic syndrome but are not a reliable indicator of general kidney function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. “I need to take sucralfate 30 minutes after meals.”: Sucralfate is most effective when taken before meals, because it creates a protective barrier over ulcers to shield them during digestion. Taking it after meals reduces its protective action and shows the patient needs more teaching.
B. “I need to report pain or vomiting of blood.”: Persistent abdominal pain or hematemesis may indicate worsening ulcers or gastrointestinal bleeding. Reporting these symptoms is appropriate and reflects correct understanding of when to seek medical attention.
C. “I need to take my antacid 30 minutes before or 30 minutes after Sucralfate.”: Antacids can interfere with sucralfate’s ability to coat the stomach lining. Spacing these medications helps maintain effectiveness, showing appropriate understanding.
D. “I need to increase my fluid intake.”: Sucralfate can cause constipation, and increased fluid intake helps reduce this risk. This statement reflects correct self-care instructions.
Correct Answer is B
Explanation
A. Request an order for a blood glucose level: TMP-SMX does not typically cause acute changes in blood glucose, so testing glucose would not clarify the cause of petechiae. Petechial rashes suggest a possible blood dyscrasia such as thrombocytopenia rather than a metabolic disturbance.
B. Hold the dose and notify the provider.: A petechial rash can signal a serious hypersensitivity reaction or drug-induced thrombocytopenia. Giving another dose could worsen the reaction and increase the risk of bleeding or systemic complications. Holding the medication and seeking immediate evaluation is the safest intervention.
C. Request an order for a BUN and creatinine level.: Although TMP-SMX can affect renal function, petechiae primarily indicate a hematologic problem rather than isolated kidney dysfunction. Checking kidney values does not address the risk for severe allergic or platelet-related complications.
D. Request an order for diphenhydramine (Benadryl): Antihistamines can help mild allergic reactions but may mask symptoms of a more serious underlying condition such as thrombocytopenia. Giving it without stopping the medication could delay correct diagnosis and treatment.
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