Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?
Serum calcium
Serum creatinine
Hemoglobin and Hematocrit
White blood cell count (WBC)
The Correct Answer is B
Serum creatinine is the most important laboratory value to review before administering an antibiotic that can cause nephrotoxicity. Nephrotoxicity is an alteration in the function of the kidney due to exposure to certain drugs or toxins.
It can be assessed by measuring the glomerular filtration rate (GFR), which is the rate of clearance of a substance from the blood by the kidneys. Serum creatinine is a waste product of muscle metabolism that is freely filtered by the glomeruli and not reabsorbed or secreted by the tubules.
Therefore, it is a reliable indicator of GFR and renal function. An increase in serum creatinine indicates a decrease in GFR and renal function, which may be caused by nephrotoxic drugs.
The other laboratory values are not directly related to nephrotoxicity or GFR:
- Serum calcium: This may be affected by renal function, but it is not a sensitive or specific marker of nephrotoxicity. It may be altered by other factors such as vitamin D, parathyroid hormone, and bone metabolism.
- Hemoglobin and hematocrit: These may be affected by renal function, but they are not sensitive or specific markers of nephrotoxicity. They may reflect the erythropoietin production by the kidneys, which stimulates red blood cell production in the bone marrow. However, they may also be influenced by other factors such as blood loss, hydration status, and iron deficiency.
- White blood cell count (WBC): This is not related to nephrotoxicity or GFR. It may reflect the presence of infection or inflammation, which may be a cause or a consequence of renal impairment, but it is not a direct measure of renal function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Encouraging the client to exercise every day to eliminate bedtime wakefulness is not appropriate advice in this scenario. It oversimplifies the issue and may not address the underlying causes of the client's sleep difficulties. Additionally, excessive exercise close to bedtime may actually interfere with sleep.
Choice C rationale:
Asking the client for a description of the exercise schedule being followed is a reasonable action. It allows the nurse to gather information about the client's exercise routine and assess whether it might be contributing to the sleep difficulties. However, this alone may not fully address the client's concerns.
Choice D rationale:
Determining the amount of weight the client has lost since increasing activity is relevant to the client's overall health and progress toward weight loss goals, but it does not directly address the issue of sleep difficulties. Weight loss and improved sleep may not always have a direct cause-and-effect relationship.
Correct Answer is D
Explanation
Choice A rationale:
An altered level of consciousness is not a typical finding in Alzheimer's disease. This condition is characterized by cognitive decline and memory impairment, but consciousness itself is not directly affected.
Choice B rationale:
Rapid mood swings can occur in individuals with Alzheimer's disease due to the changes in brain structure and function. These mood swings are a common behavioral symptom. However, the more distinctive hallmark of Alzheimer's disease is the cognitive decline rather than mood swings.
Choice C rationale:
Excessive motor activity is not a prominent feature of Alzheimer's disease. Instead, individuals with Alzheimer's disease often experience a decline in motor skills and coordination as the disease progresses.
Choice D rationale:
Failure to recognize familiar objects is a common symptom of Alzheimer's disease. This is referred to as agnosia, where individuals may struggle to recognize familiar people, objects, or places. It results from the progressive damage to brain regions responsible for memory and sensory processing.
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