A nurse is reviewing the BUN result of a client who is taking cyclosporine following a kidney transplant. Which of the following laboratory studies should the nurse recognize as another renal function study that should be monitored?

Rationale:

• Deep tendon patellar reflex: The reflex response decreased from 4+ to 2+, demonstrating a reduction in hyperreflexia. This improvement indicates effective magnesium sulfate therapy, showing decreased neuromuscular irritability and a lower risk of progression to eclampsia.

• Blood pressure: The blood pressure declined from 166/110 mm Hg to 152/90 mm Hg, reflecting effective antihypertensive therapy and improved vascular tone. This moderate reduction suggests that labetalol and magnesium sulfate are successfully controlling severe preeclampsia symptoms.

• Heart rate: The heart rate remained within normal parameters (72–90/min) across both days, showing stable cardiac function without significant deviation. This consistency indicates no notable change in hemodynamic status related to treatment.

• Edema: The client continues to exhibit +3 pitting edema in both lower extremities, reflecting persistent fluid retention and endothelial dysfunction. This ongoing finding suggests that intravascular fluid shifts typical of preeclampsia have not yet resolved.

Rationale:
A. Beneficence: Beneficence involves promoting the well-being of clients. While both clients’ needs are important, the issue here is unequal access to resources, not the nurse’s intent to benefit them.

B. Autonomy: Autonomy relates to the client’s right to make informed decisions about their own care. The situation does not interfere with either client’s ability to make choices.

C. Nonmaleficence: Nonmaleficence means avoiding harm. Although delayed access to supplies could indirectly cause harm, the primary ethical concern is the fairness in distribution, not direct harm by action.

D. Justice: Justice involves fairness and equitable treatment. Providing supplies to one client based on insurance status while requiring the other to obtain them elsewhere reflects unequal treatment and a breach of the principle of justice.