A nurse is reviewing the laboratory reports of a client who is undergoing nutritional screening due to a risk for chronic kidney disease. The nurse should identify that which of the following results indicates the need for further assessment?
A.
Serum creatinine 3.5 mg/dL
B.
Hematocrit 45%
C.
Blood urea nitrogen 18 mg/dL
D.
Sodium 140 mEq/L
The correct answer and Explanation is :
The correct answer is A. Serum creatinine 3.5 mg/dL.
Explanation:
In patients at risk for chronic kidney disease (CKD), serum creatinine levels are critical indicators of kidney function. Normal serum creatinine levels typically range from approximately 0.6 to 1.2 mg/dL, depending on factors such as age, sex, and muscle mass. A serum creatinine level of 3.5 mg/dL is significantly elevated and suggests impaired kidney function, which necessitates further assessment.
Elevated serum creatinine indicates that the kidneys are not effectively clearing creatinine from the bloodstream, leading to its accumulation. In the context of CKD, rising creatinine levels can signify a decline in the glomerular filtration rate (GFR), which is a crucial parameter for evaluating kidney function. A GFR below 60 mL/min for three months or longer is indicative of CKD.
Comparison with Other Options:
- B. Hematocrit 45%: This value is within the normal range for adults, which is typically around 38.3% to 48.6% for men and 35.5% to 44.9% for women. A hematocrit of 45% does not indicate an immediate need for further assessment regarding kidney function.
- C. Blood urea nitrogen (BUN) 18 mg/dL: This result is also within the normal range (7-20 mg/dL). Although BUN can be affected by factors like protein intake and hydration status, it does not directly indicate kidney damage.
- D. Sodium 140 mEq/L: This value is considered normal (135-145 mEq/L). Sodium levels can fluctuate with various conditions, but this reading does not suggest any immediate concern related to kidney function.
In summary, a serum creatinine level of 3.5 mg/dL is a critical finding in a patient at risk for CKD, signaling the need for further investigation to determine the extent of kidney impairment and to initiate appropriate management.