A nurse is monitoring a client who is dehydrated. Which of the following laboratory findings should the nurse report to the provider?

Hematocrit 45% (37% to 52%)

Creatinine 0.9 mg/dL (0.5-1.2 mg/dL)

BUN 25 mg/dL (10-20 mg/dL)

Urine specific gravity 1.028 (1.005 to 1.030)

Answer and Explanation

The Correct Answer is C

A. Hematocrit 45% (37% to 52%): This value is within the normal range for hematocrit. Dehydration may increase the hematocrit due to a relative increase in red blood cell concentration, but 45% is still within normal limits.

B. Creatinine 0.9 mg/dL (0.5-1.2 mg/dL): This value is within the normal range for creatinine, indicating normal kidney function.

C. BUN 25 mg/dL (10-20 mg/dL): An elevated BUN level is a sign of dehydration as it reflects increased protein breakdown and decreased renal perfusion. This value is above the normal range and should be reported to the provider.

D. Urine specific gravity 1.028 (1.005 to 1.030): This value is within the normal range and indicates that the kidneys are concentrating urine, which is typical in dehydration as the body tries to conserve water.

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Correct Answer is B

Explanation

A. Dextrose 10% in water: Dextrose solutions provide calories but do not restore volume or replace electrolytes. They are not typically used in hypovolemic shock.

B. Lactated Ringer's: Lactated Ringer’s solution is an isotonic solution containing sodium, potassium, calcium, and lactate, which helps restore both fluid volume and electrolytes in the case of hypovolemic shock. It is commonly used while awaiting blood transfusions.

C. 0.33% sodium chloride: This is a hypotonic solution that can cause fluid to shift into cells and is not appropriate for fluid resuscitation in hypovolemia, which requires an isotonic solution.

D. 0.45% sodium chloride: This is a hypotonic solution as well, and it could worsen hypotension by causing fluid shifts into the cells, which is not ideal for treating hypovolemic shock.

A. Hypotension B. Decreased deep tendon reflexes C. Diarrhea D. Increased appetite

Correct Answer is B

Explanation

A. Hypotension: Hypercalcemia (high calcium levels) typically causes increased blood pressure, not hypotension.

B. Decreased deep tendon reflexes: High calcium levels can depress neuromuscular function, leading to diminished or absent deep tendon reflexes. This is a common finding in hypercalcemia.

C. Diarrhea: Hypercalcemia is more commonly associated with constipation, not diarrhea.

D. Increased appetite: Hypercalcemia does not cause increased appetite. It often leads to symptoms such as nausea, vomiting, or a reduced appetite.

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A nurse is monitoring a client who is dehydrated. Which of the following laboratory findings should the nurse report to the provider?

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