The client has been diagnosed with chronic kidney disease (CKD).
Which of the following lab values should the nurse monitor to assess for renal function?
Blood glucose level.
Serum creatinine level.
Serum albumin level.
White blood cell count.
The Correct Answer is B
Serum creatinine is a waste product that comes from muscle activity and is normally removed by the kidneys.
When the kidneys are damaged, the serum creatinine level rises.
The glomerular filtration rate (GFR) is a measure of how well the kidneys are filtering the blood and it is calculated from the serum creatinine level.
A normal GFR is 60 or more, while a GFR below 60 may indicate kidney disease.
Therefore, monitoring the serum creatinine level and the GFR can help assess the renal function in CKD.
Choice A is wrong because blood glucose level is not a direct indicator of renal function, although high blood glucose can damage the kidneys over time.
Choice C is wrong because serum albumin level is not a specific marker of renal function, although low serum albumin can be caused by protein loss in the urine due to kidney damage.
Choice D is wrong because white blood cell count is not related to renal function, but rather to immune system activity and infection.
Normal ranges for serum creatinine are 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women.
Normal ranges for GFR are 90 to 120 mL/min.
Normal ranges for serum albumin are 3.4 to 5.4 g/dL1.
Normal ranges for white blood cell count are 4,000 to 11,000 cells per microliter.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is A. 42 mL/h.
Choice A: 42 mL/h
Reason: To calculate the IV rate, we use the formula: IV rate (mL/h) = Total volume (mL) ÷ Total time (hours). For this problem, the total volume is 1000 mL and the total time is 24 hours. Therefore, the calculation is 1000 mL ÷ 24 hours = 41.6667 mL/h. When rounded to the nearest whole number, the IV rate is 42 mL/h. This makes 42 mL/h the correct answer.
Choice B: 44 mL/h
Reason: This choice is incorrect because it does not match the calculated IV rate. The calculation of 1000 mL ÷ 24 hours results in 41.6667 mL/h, which rounds to 42 mL/h, not 44 mL/h. Therefore, 44 mL/h is not a valid option based on the given data.
Choice C: 46 mL/h
Reason: This choice is also incorrect. The calculated IV rate of 41.6667 mL/h, when rounded to the nearest whole number, is 42 mL/h. There is no mathematical basis for rounding up to 46 mL/h from 41.6667 mL/h, making this choice invalid.
Choice D: 48 mL/h
Reason: This choice is incorrect as well. The correct calculation yields 41.6667 mL/h, which rounds to 42 mL/h. There is no justification for rounding up to 48 mL/h. This choice does not align with the calculated and rounded IV rate.
Correct Answer is A
Explanation
The correct answer is choice A. Daily weight.
According to MDCalc, daily weight is the most accurate indicator of fluid loss or gain in acutely ill patients, as it reflects changes in total body water.
A weight change of 1 kg corresponds to a fluid change of approximately 1 L.
Choice B is wrong because intake and output measurements can be inaccurate or incomplete, and do not account for insensible fluid losses.
Choice C is wrong because serum osmolality reflects the concentration of solutes in the blood, not the volume of fluid.
Choice D is wrong because urine specific gravity reflects the concentration of solutes in the urine, not the volume of fluid.
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