A practical nurse (PN) is reviewing the morning laboratory results for a 72-year-old clien… — NCLEX-PN

A practical nurse (PN) is reviewing the morning laboratory results for a $72$ -year-old client who is scheduled for a computed tomography (CT) scan with intravenous (IV) contrast later this morning. The client was admitted yesterday with community-acquired pneumonia. Which laboratory finding indicates the highest risk for a potential procedure-related complication and should be reported to the registered nurse (RN) immediately?

A
White blood cell (WBC) count of $14,500/\text{mm}^3$
B
Blood urea nitrogen (BUN) level of $18\text{ mg/dL}$
Serum creatinine level of $2.4\text{ mg/dL}$ Answer
D
Serum potassium level of $4.1\text{ mEq/L}$

Answer

Serum creatinine level of

2.4\text{ mg/dL}

IV contrast media is nephrotoxic. A serum creatinine level of

2.4\text{ mg/dL}

is abnormally high (normal is approximately

0.6-1.2\text{ mg/dL}

) and indicates impaired renal function. Administering contrast dye to this client significantly increases the risk of contrast-induced nephropathy (acute kidney injury). The PN must report this to the RN immediately so the provider can modify the diagnostic plan.

Step-by-Step Solution

Analyze the scheduled procedure and its associated risks.

The client is scheduled for a CT scan with IV contrast. IV contrast dye is nephrotoxic and can cause contrast-induced nephropathy.

Identifying the specific risks of a procedure is essential for anticipating complications and ensuring client safety.

Evaluate the laboratory results to determine if any values indicate a high risk for the procedure.

The serum creatinine level of

2.4\text{ mg/dL}

is significantly elevated above the normal range (typically

0.6-1.2\text{ mg/dL}

), indicating impaired renal function.

Administering nephrotoxic contrast dye to a client with preexisting renal impairment poses a severe risk of acute kidney injury.

Determine the appropriate nursing action based on the LPN scope of practice.

The PN must immediately report the elevated creatinine to the RN or healthcare provider.

The provider must be notified to potentially cancel the scan, order intravenous hydration, or utilize an imaging modality without contrast to protect the client's kidneys.

Key Concept

Assessing laboratory values for procedure-related risks

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