The nurse is caring for a client who just returned to the nursing unit following a cardiac angiogram and stent insertion. Which action should the nurse implement first?

Choice A reason: This is the most concerning result for the nurse. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in the urine. A high creatinine level indicates impaired kidney function, which can be a complication of hypertension. The normal range of creatinine is 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women. A creatinine level of 3.2 mg/dL is more than twice the upper limit of normal and suggests severe kidney damage.

Choice B reason: This is not a concerning result for the nurse. Potassium is an electrolyte that is essential for the function of nerves and muscles, especially the heart. The normal range of potassium is 3.5 to 5.0 mEq/L. A potassium level of 3.4 mEq/L is slightly below the normal range, but not enough to cause serious problems. A low potassium level can be caused by diuretics, vomiting, diarrhea, or excessive sweating. The nurse should monitor the client's potassium level and symptoms, and advise the client to eat foods that are high in potassium, such as bananas, oranges, potatoes, and tomatoes.

Choice C reason: This is not a concerning result for the nurse. Hemoglobin is a protein in the red blood cells that carries oxygen to the tissues. The normal range of hemoglobin is 13.5 to 17.5 g/dL for men and 12.0 to 15.5 g/dL for women. A hemoglobin level of 12.8 g/dL is within the normal range for women and slightly below the normal range for men, but not enough to cause significant anemia. A low hemoglobin level can be caused by blood loss, iron deficiency, or bone marrow disorders. The nurse should assess the client's history, diet, and symptoms, and check for other signs of anemia, such as pallor, fatigue, and shortness of breath.

Choice D reason: This is not a concerning result for the nurse. Blood urea nitrogen (BUN) is a waste product of protein metabolism that is filtered by the kidneys and excreted in the urine. A high BUN level indicates impaired kidney function or dehydration. The normal range of BUN is 7 to 20 mg/dL. A BUN level of 20 mg/dL is at the upper limit of normal, but not enough to indicate serious kidney problems. The nurse should ensure that the client is well hydrated and monitor the client's urine output and specific gravity.

Choice A reason: Admission blood pressure is 110/70 is not the information that the nurse must report to the health care provider prior to the procedure. This is a normal blood pressure reading for an adult client and does not indicate any contraindication or complication for the cardiac angiogram.

Choice B reason: Client has multiple food and drug allergies is the information that the nurse must report to the health care provider prior to the procedure. This is a critical information that may affect the choice of contrast agent, medications, or equipment used for the cardiac angiogram. The nurse should identify the specific allergens and the type and severity of the allergic reactions that the client has experienced in the past.

Choice C reason: Pedal pulses are 1+ bilaterally is not the information that the nurse must report to the health care provider prior to the procedure. This is a low-normal finding for the strength of the peripheral pulses and does not indicate any significant vascular impairment or obstruction. The nurse should document and monitor the pedal pulses, but not necessarily report them.

Choice D reason: Client is slightly anxious is not the information that the nurse must report to the health care provider prior to the procedure. This is a common and expected emotional response for a client who is undergoing an invasive diagnostic test and does not require any immediate intervention. The nurse should provide reassurance and education to the client and address any concerns or questions that they may have.