Medical Surgical Labs BMP #2

Question

The nurse arrives for her 7a shift and receives report on a client who has had 300 mL of urine output in the last 24 hours with a BUN of 38 mg/dL and creatinine of 2 mg/dL. What action should the nurse take next?

Answers

  1. Report findings to HCP and request an order for a diuretic.
    • Rationale:

      This answer is not correct because it is not the next action that should be taken by the nurse. More assessment and lab studies may be indicated before a diuretic is issued.

  2. Assess for signs of excess fluid volume and report all findings to HCP.
    • Rationale:

      This answer is correct because the labs and oliguria indicate acute kidney injury. The nurse should assess for signs of excess fluid volume and report findings to the HCP. Signs of excess fluid volume include edema, jugular vein distention, hypertension, lung crackles, and increased respiratory rate.

  3. Place the client on fluid restriction and a low-protein diet and report to HCP.
    • Rationale:

      This answer is not correct because it is not the next action the nurse should take. Though, placing the client on fluid restriction and changing the diet to a low protein diet may be an intervention the HCP orders.

  4. Obtain an order for IV fluids and encourage p.o. intake.
    • Rationale:

      This answer is not correct because the client should be assessed for excess fluid volume first. Volume replacement may be indicated, depending on which stage of kidney failure the client presents. Diuretics are used cautiously in clients with acute renal failure.

Overview

BUN and creatinine measure kidney function. When BUN and creatinine are both elevated, this indicates kidney failure.

Explanation

Learning Outcomes

BUN and creatinine measure kidney function. When BUN and creatinine are both elevated, this indicates kidney failure. The nurse should assess for signs of excess fluid volume and report findings to the HCP. Signs of excess fluid volume include edema, jugular vein distention, hypertension, lung crackles, and increased respiratory rate. Volume replacement may be indicated, depending on which stage of kidney failure the client presents. Diuretics are used cautiously in clients with acute renal failure.

Test Taking Tip

If there is a choice that pertains to assessment of the client, choose that answer. Assess the client first, before implementing treatment.

Video Rationale