While changing the dressing of a client who is immobile, the practical nurse (PN) observes a red and swollen wound with a moderate amount of yellow and green drainage and a foul odor.

Before reporting this finding to the healthcare provider, the PN should evaluate which of the client's laboratory values?

Tell the client that the PN will verify that the dispensed medication is the valid prescription. Choice A rationale:

Explaining that the healthcare provider probably prescribed a different medication while the client is hospitalized (Choice A) may create confusion or concern for the client. It is essential to reassure the client and take appropriate action to address the discrepancy in the appearance of the medication.

Choice C rationale:

Explaining that the pharmacy often substitutes generic equivalents for more expensive brands (Choice C) is not applicable in this situation since the client is expressing concern about the appearance of the medication prescribed by the healthcare provider, not a substitution by the pharmacy.

Choice D rationale:

Telling the client that he is probably confused since being hospitalized tends to disorient clients (Choice D) is dismissive of the client's concerns. It is crucial to acknowledge the client's observation and address the issue professionally.

The correct answer is choice B, Serum creatinine. Choice A rationale:

The white blood cell count (WBC) is an important parameter for assessing the body's immune response to infections. While it can provide valuable information about the presence of an infection, it is not directly related to nephrotoxicity. Therefore, it is not the most important laboratory value to review before administering an antibiotic that can cause nephrotoxicity.

Choice B rationale:

Serum creatinine is a crucial laboratory value to assess kidney function. It is a waste product that is filtered by the kidneys, and its level in the blood is a reliable indicator of kidney function. If the serum creatinine level is elevated, it suggests impaired kidney function, which can be a warning sign of nephrotoxicity. Reviewing the serum creatinine level before administering nephrotoxic antibiotics is essential to ensure that the client's kidneys are functioning adequately and to avoid potential harm.

Choice C rationale:

Hemoglobin and hematocrit are indicators of the client's red blood cell count and blood's oxygen-carrying capacity. While these values can provide information about the client's overall health status, they are not directly related to nephrotoxicity. Therefore, they are not the most important laboratory values to review in this particular scenario.

Choice D rationale:

Serum calcium levels are essential for assessing bone health, nerve function, and muscle contractions. However, they are not directly related to nephrotoxicity, and reviewing serum calcium levels alone would not provide sufficient information about kidney function. Hence, it is not the most critical value to review before administering nephrotoxic antibiotics