A client who has polycystic kidney disease (PKD) presents to the emergency department with reports of a severe headache. Which of the following complications should the nurse expect?

Choice A reason: The serum creatinine test measures the amount of creatinine in the blood and provides information about kidney function. Normal ranges for serum creatinine levels are 0.74 to 1.35 mg/dL for adult men and 0.59 to

1.04 mg/dL for adult women. This test is a common way to assess renal function and can indicate if the kidneys are not filtering waste effectively.

Choice B reason: While a serum creatinine test can indicate severe renal impairment, it does not diagnose a specific disease. Further testing would be required to determine the presence of a particular renal disease.

Choice C reason: The serum creatinine test does not directly show if medications are affecting kidney function. However, if a patient is on medications known to affect the kidneys, such as certain steroids, changes in creatinine levels can suggest an impact on renal function.

Choice D reason: It is part of the nurse's role to provide information about tests and procedures. Telling a patient to ask the doctor does not offer immediate support or information, which can be important for patient care and understanding.

The correct answer is D. Urine output 75 mL in 1 hr.

Adequate urine output (at least 30 mL/hr) indicates effective hydration, showing that the kidneys are functioning properly and fluid balance is improving. A urine output of 75 mL in 1 hour suggests sufficient fluid replacement.

Here’s why the other options are incorrect:

• A. Urine specific gravity 1.005 to 1.030 – This range covers both normal and abnormal values. In dehydration, urine specific gravity is usually high (>1.030) due to concentrated urine. Effective treatment should lead to lower urine specific gravity, but the full range does not confirm improvement.

• B. Decreased pulse pressure – Pulse pressure is the difference between systolic and diastolic blood pressure. Dehydration typically causes a narrowed pulse pressure, so improvement should lead to a normal or increased pulse pressure rather than a decrease.

• C. Lightheadedness – Dizziness and lightheadedness are signs of dehydration-related hypotension. Effective hydration should resolve these symptoms, not maintain them.