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?
Bilirubin
Alkaline phosphatase
Amylase
Creatinine
The Correct Answer is D
Choice A reason: Bilirubin assesses liver function, not kidneys. Cyclosporine’s nephrotoxicity affects glomerular filtration, not heme metabolism. Monitoring bilirubin is irrelevant for renal function in transplant clients, as it reflects hepatic or hemolytic processes, not kidney health or drug toxicity.
Choice B reason: Alkaline phosphatase evaluates liver or bone health, not kidneys. Cyclosporine may cause hepatotoxicity, but renal monitoring is critical due to its nephrotoxic potential. Alkaline phosphatase does not reflect glomerular or tubular function, making it unsuitable for assessing renal impact.
Choice C reason: Amylase measures pancreatic function, not kidneys. Cyclosporine’s nephrotoxicity affects renal filtration, not pancreatic enzymes. Monitoring amylase is irrelevant for kidney transplant clients, as it does not indicate renal impairment or cyclosporine’s toxic effects on kidney function.
Choice D reason: Creatinine is a key renal function marker, reflecting glomerular filtration rate. Cyclosporine’s nephrotoxicity elevates creatinine, indicating kidney damage. Monitoring it with BUN ensures early detection of renal impairment, guiding dose adjustments to prevent further injury in transplant clients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A WBC count of 1,300/mm³ indicates severe leukopenia, a contraindication for clozapine due to its risk of agranulocytosis. Low white cells increase infection risk, requiring immediate discontinuation or monitoring per FDA guidelines, making this the critical finding to identify.
Choice B reason: Hemoglobin of 16 g/dL is within normal range (14-18 g/dL) and does not contraindicate clozapine use. Normal hemoglobin supports adequate oxygen transport, so this finding is unremarkable and incorrect for identifying a contraindication.
Choice C reason: Fasting blood glucose of 124 mg/dL indicates mild elevation but is not a contraindication for clozapine, which may worsen glucose control. Monitoring is needed, but this level does not preclude use, making it incorrect.
Choice D reason: Platelet count of 200,000/mm³ is normal (150,000-450,000/mm³) and does not contraindicate clozapine. Normal platelets ensure proper clotting, so this finding is not a concern for clozapine administration, making it incorrect.
Correct Answer is B
Explanation
Choice A reason: Warming blood products prevents hypothermia during transfusion but is not the priority in a trauma patient. Airway management takes precedence, as oxygenation is critical to survival. Administering blood products comes later in the trauma algorithm, after securing the airway and stabilizing breathing, making this action secondary.
Choice B reason: Establishing a patent oral airway is the first priority in trauma care, following the ABCs (Airway, Breathing, Circulation). A clear airway ensures oxygenation, critical for preventing hypoxia in a patient with multiple injuries. Without a patent airway, other interventions are ineffective, as oxygen delivery is essential for survival and organ function.
Choice C reason: Creating a sterile field for wound care is important to prevent infection but is not the first priority in a trauma patient. Airway and breathing take precedence, as immediate life-threatening issues like hypoxia or shock must be addressed before wound care, making this action lower in priority.
Choice D reason: Administering IV fluids to maintain blood pressure is part of the circulation phase in trauma care but follows airway and breathing stabilization. Without a patent airway, fluid administration cannot address hypoxia, a primary cause of mortality in trauma. This action is secondary to ensuring airway patency.
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