The nurse is caring for a client who has been diagnosed with acute renal failure. Which of the following laboratory data is the most accurate indicator to the nurse that a client with acute renal failure has met the expected outcomes?
1. Decreasing blood urea nitrogen (BUN) levels
2. Decreasing serum creatinine
3. Decreasing neutrophil count
4. Decreasing lymphocyte count
2. Decreasing serum creatinine
Rationale:
Creatinine is the metabolic end product of creatine phosphate and is excreted via the kidneys in relatively constant amounts. BUN, a measurement of the nitrogen portion of urea, is also excreted in urine and is a good indicator of renal function. However, conditions that increase protein catabolism also cause a rise in BUN levels. Therefore, the serum creatinine levels are more appropriate to evaluate in determining the return of renal function. Neutrophils and lymphocytes are not used to monitor the return of renal function.
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