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Which laboratory value is most indicative of chronic kidney disease (CKD)?

A.

Potassium level of 4.0 mEq/L

B.

Blood urea nitrogen (BUN) of 18 mg/dL

C.

Serum creatinine of 5.0 mg/dL

D.

Urine specific gravity of 1.015

Answer and Explanation

The Correct Answer is C

(A) Potassium level of 4.0 mEq/L: Normal range (3.5-5.0 mEq/L), does not indicate CKD.

(B) Blood urea nitrogen (BUN) of 18 mg/dL: BUN can fluctuate with hydration status and is not the most specific CKD marker.

(C) Serum creatinine of 5.0 mg/dL: Creatinine is a direct marker of kidney function. A level above 1.2 mg/dL suggests dysfunction, and 5.0 mg/dL is severely elevated, indicating CKD.

(D) Urine specific gravity of 1.015: Falls within the normal range (1.010-1.030), does not indicate CKD.

 


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Correct Answer is D

Explanation

(A) Restrict the patient’s fluid intake: Fluid restrictions are important but not the priority during administration. Monitoring for adverse effects like ototoxicity is more critical.

(B) Ensure the patient voids before administration: Furosemide is a diuretic, but voiding before administration is not required.

(C) Administer the dose rapidly to achieve quick results: Rapid IV push can cause ototoxicity and hypotension. It should be given slowly over 1-2 minutes.

(D) Monitor the patient for tinnitus: High-dose or rapid IV administration of furosemide can cause ototoxicity, leading to tinnitus and hearing loss.

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