A nurse is reviewing the BUN and creatinine levels of an older adult patient with chronic kidney disease. The nurse should anticipate which of the following findings?
BUN 8 mg/dL and creatinine 0.7 mg/dL
BUN 45 mg/dL and creatinine 8 mg/dL
BUN 23 mg/dL and creatinine 1.0 mg/dL
BUN 10 mg/dL and creatinine 0.3 mg/dL
The Correct Answer is B
Choice A reason:
A BUN level of 8 mg/dL and a creatinine level of 0.7 mg/dL are within normal ranges for a healthy individual without kidney disease. In chronic kidney disease (CKD), we would expect these values to be elevated due to the kidneys' reduced ability to filter waste products from the blood.
Choice B reason:
A BUN level of 45 mg/dL and a creatinine level of 8 mg/dL are significantly higher than the normal range, which is consistent with impaired kidney function seen in CKD. These elevated levels indicate that the kidneys are not effectively filtering urea and creatinine from the blood, leading to their accumulation.
Choice C reason:
A BUN level of 23 mg/dL and a creatinine level of 1.0 mg/dL could be seen in the early stages of CKD. While the creatinine level is within the normal range, the BUN level is slightly elevated, which may suggest a decline in kidney function.
Choice D reason:
A BUN level of 10 mg/dL and a creatinine level of 0.3 mg/dL are both below the normal range. This is an unlikely finding for a patient with CKD, as kidney impairment typically leads to increased levels of these substances in the blood.
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Correct Answer is ["B","C","D","E"]
Explanation
Choice A reason:
Cold extremities are not a typical symptom associated with Paget's disease of the bone. This condition usually does not affect the temperature of the limbs directly.
Choice B reason:
Skeletal pain is a common symptom in Paget's disease due to the abnormal bone remodeling process. The affected bones may become painful, especially in the pelvis, spine, skull, and long bones.
Choice C reason:
Visual loss can occur if Paget's disease affects the skull, leading to increased pressure on the nerves associated with vision. This pressure can result in visual impairment or loss.
Choice D reason:
Cranial enlargement is a possible finding in Paget's disease when the skull is involved. The abnormal bone growth can cause the skull to increase in size.
Choice E reason:
An abnormal gait may develop if Paget's disease affects the legs, causing the bones to bow and leading to difficulty walking.
Correct Answer is D
Explanation
Choice A reason:
Urine-specific gravity measures the concentration of urine compared to water. It can indicate various conditions affecting the kidneys, but it does not provide a direct measure of renal function. It can be affected by hydration status and does not specifically reflect kidney damage or disease.
Choice B reason:
Blood urea nitrogen (BUN) levels can indicate kidney health; however, BUN can also be influenced by factors such as protein intake, hydration, and liver function. Therefore, while it is a useful test, it is not the most specific indicator of renal function in isolation.
Choice C reason:
Serum sodium levels are important for assessing electrolyte balance and can be affected by kidney function. However, changes in serum sodium are not specific to kidney function alone and can result from a variety of conditions.
Choice D reason:
Serum creatinine is a waste product from the normal breakdown of muscle tissue. As the kidneys are responsible for filtering out creatinine, its level in the blood is a good indication of kidney function. Elevated levels of serum creatinine may indicate impaired kidney function or kidney disease. In the context of SLE, where kidney involvement is common, serum creatinine is a crucial marker for monitoring renal function.