A nurse reviews laboratory results for a client who was admitted ...

[TFauchery]

A nurse reviews laboratory results for a client who was admitted for a myocardial infarction and cardiogenic shock 2 days ago. Which laboratory test result should the nurse expect to find?
 
  a. Blood urea nitrogen (BUN) of 52 mg/dL
  b. Creatinine of 2.3 mg/dL
  c. BUN of 10 mg/dL
  d. BUN/creatinine ratio of 8:1

Question 2

A nurse reviews the health history of a client with an oversecretion of renin. Which disorder should the nurse correlate with this assessment finding?
 
  a. Alzheimer's disease
  b. Hypertension
  c. Diabetes mellitus
  d. Viral hepatitis

[Brummell1998]

Answer to Question 1

ANS: A
Shock leads to decreased renal perfusion. An elevated BUN accompanies this condition. The creatinine should be normal because no kidney damage occurred. A low BUN signifies overhydration, malnutrition, or liver damage. A low BUN/creatinine ratio indicates fluid volume excess or acute renal tubular acidosis.

Answer to Question 2

ANS: B
Renin is secreted when special cells in the distal convoluted tubule, called the macula densa, sense changes in blood volume and pressure. When the macula densa cells sense that blood volume, blood pressure, or blood sodium levels are low, renin is secreted. Renin then converts angiotensinogen into angiotensin I. This leads to a series of reactions that cause secretion of the hormone aldosterone. This hormone increases kidney reabsorption of sodium and water, increasing blood pressure, blood volume, and blood sodium levels. Inappropriate or excessive renin secretion is a major cause of persistent hypertension. Renin has no impact on Alzheimer's disease, diabetes mellitus, or viral hepatitis.