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
Explanation
Choice A reason:
This statement is misleading. While many herbal therapies are generally considered safe, they can have side effects and interact with other medications. It is important to consult with a healthcare provider before starting any new herbal therapy.
Choice B reason:
This statement is accurate. Many herbal products have not been subjected to rigorous long-term testing that is required for conventional medications. Therefore, their long-term safety and efficacy profiles are not always well-established.
Choice C reason:
This statement is incorrect. Some herbal therapies have been found to be beneficial in reducing menopausal discomfort, such as hot flashes and night sweats. However, their effectiveness can vary from person to person.
Choice D reason:
This statement is not advisable without further assessment. While some herbal therapies may help with menopausal symptoms, it is important for the client to discuss with a healthcare provider to consider personal health history, potential side effects, and interactions with other medications.
Correct Answer is A
Explanation
Choice a) Raloxifene:
Raloxifene is part of a class of drugs known as selective estrogen-receptor modulators (SERMs). It works by imitating the beneficial effects of the hormone estrogen on your bones, helping to prevent bone loss and improve density. Therefore, it is used in the prevention and treatment of osteoporosis.
Choice b) Calcitonin:
Calcitonin is a hormone that a person’s thyroid gland produces. It helps regulate the amount of calcium in the body. For the treatment of postmenopausal osteoporosis, scientists typically extract calcitonin from salmon. This is because salmon calcitonin has a much higher potency than human calcitonin. Osteoclasts are cells in the body that degrade bone. Calcitonin can inhibit osteoclasts. This helps slow the loss of bone density and increases bone mass, hindering the progression of osteoporosis.
Choice c) Allopurinol:
Allopurinol is primarily used to treat gout and certain types of kidney stones. It is not typically used in the prevention or treatment of osteoporosis.
Choice d) Levothyroxine:
Levothyroxine is used to treat hypothyroidism (underactive thyroid). It is not typically used in the prevention or treatment of osteoporosis. However, if you are prescribed levothyroxine you should have regular blood tests, at least once a year, to ensure your thyroid hormone levels are not too high. Continuous high thyroid hormone levels may lead to developing or worsening of low bone density and osteoporosis.
