Author Question: A male client comes into the emergency department with a serum creatinine of 2.2 mg/dL and a blood ... (Read 344 times)

mia · **on:** Jun 25, 2018

A male client comes into the emergency department with a serum creatinine of 2.2 mg/dL and a blood urea nitrogen (BUN) of 24 mL/dL. What question should the nurse ask first when taking this client's history?

a. Have you been taking any aspirin, ibuprofen, or naproxen recently?
b. Do you have anyone in your family with renal failure?
c. Have you had a diet that is low in protein recently?
d. Has a relative had a kidney transplant lately?

Question 2

A marathon runner comes into the clinic and states I have not urinated very much in the last few days. The nurse notes a heart rate of 110 beats/min and a blood pressure of 86/58 mm Hg. Which action by the nurse is the priority?

a. Give the client a bottle of water immediately.
b. Start an intravenous line for fluids.
c. Teach the client to drink 2 to 3 liters of water daily.
d. Perform an electrocardiogram.

ntsoane kedibone · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
There are some medications that are nephrotoxic, such as the nonsteroidal anti-inflammatory drugs ibuprofen, aspirin, and naproxen. This would be a good question to initially ask the client since both the serum creatinine and BUN are elevated, indicating some renal problems. A family history of renal failure and kidney transplantation would not be part of the questioning and could cause anxiety in the client. A diet high in protein could be a factor in an increased BUN.

Answer to Question 2

ANS: A
This athlete is mildly dehydrated as evidenced by the higher heart rate and lower blood pressure. The nurse can start hydrating the client with a bottle of water first, followed by teaching the client to drink 2 to 3 liters of water each day. An intravenous line may be ordered later, after the client's degree of dehydration is assessed. An electrocardiogram is not necessary at this time.