The nurse is reviewing the serum creatinine laboratory results ...

[dmcintosh]

The nurse is reviewing the serum creatinine laboratory results for a group of patients. The nurse identifies which patients as being at risk for having falsely altered serum creatinine levels?
 
  Select all that apply.
  1. patient with rhinovirus taking 10,000 mg of vitamin C daily
  2. patient with Parkinson disease and a prescription for methyldopa
  3. patient with bipolar disorder and a prescription for lithium carbonate
  4. patient with acne vulgaris and a prescription for tetracycline
  5. patient with insomnia taking over-the-counter melatonin

Question 2

The nurse suspects a patient is experiencing a distended bladder. Which patient statement did the nurse use to make this determination?
 
  1. I am in pain, and it is worse when I press on my abdomen.
  2. My back is killing me.
  3. It feels like someone is stabbing me in the abdomen with a knife.
  4. It hurts constantly with spasms once in a while.

[vkodali]

Answer to Question 1

Correct Answer: 1, 2, 3
For the serum creatinine level, assess the patient's medications because values may be affected by ascorbic acid, methyldopa, and lithium carbonate. Tetracycline and melatonin are not identified as affecting the serum creatinine level.

Answer to Question 2

Correct Answer: 1
The patient with a distended bladder experiences constant pain increased by any pressure over the bladder. Kidney pain is experienced in the back and the costovertebral angle (the angle between the lower ribs and adjacent vertebrae) and may spread toward the umbilicus. Renal colic (pain in response to renal calculi moving through the ureter) is severe, sharp, stabbing, and excruciating; often it is felt in the flank, bladder, urethra, testes, or ovaries. Bladder and urethral pain is usually dull and continuous but may be experienced as spasms.