A nurse contacts the health care provider after reviewing a ...

[RODY.ELKHALIL]

A nurse contacts the health care provider after reviewing a client's laboratory results and noting a blood urea nitrogen (BUN) of 35 mg/dL and a creatinine of 1.0 mg/dL. For which action should the nurse recommend a prescription?
 
  a. Intravenous fluids
  b. Hemodialysis
  c. Fluid restriction
  d. Urine culture and sensitivity

Question 2

A nurse cares for a client with an increased blood urea nitrogen (BUN)/creatinine ratio. Which action should the nurse take first?
 
  a. Assess the client's dietary habits.
  b. Inquire about the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
  c. Hold the client's metformin (Glucophage).
  d. Contact the health care provider immediately.

[Bsand8]

Answer to Question 1

ANS: A
Normal BUN is 10 to 20 mg/dL. Normal creatinine is 0.6 to 1.2 mg/dL (males) or 0.5 to 1.1 mg/dL (females). Creatinine is more specific for kidney function than BUN, because BUN can be affected by several factors (dehydration, high-protein diet, and catabolism). This client's creatinine is normal, which suggests a non-renal cause for the elevated BUN. A common cause of increased BUN is dehydration, so the nurse should anticipate giving the client more fluids, not placing the client on fluid restrictions. Hemodialysis is not an appropriate treatment for dehydration. The lab results do not indicate an infection; therefore, a urine culture and sensitivity is not appropriate.

Answer to Question 2

ANS: A
An elevated BUN/creatinine ratio is often indicative of dehydration, urinary obstruction, catabolism, or a high-protein diet. The nurse should inquire about the client's dietary habits. Kidney damage related to NSAID use most likely would manifest with elevations in both BUN and creatinine, but no change in the ratio. The nurse should obtain more assessment data before holding any medications or contacting the provider.

[RODY.ELKHALIL]

TYSM

[amcvicar]

Excellent