A thin older adult woman is admitted to the hospital after several days of vomiting, diarrhea, and poor intake of foods and fluids. She has not voided since admission

Question

In preparing to care for this patient, the nurse will look for what laboratory values to help guide medication administration? (Select all that apply.) a. Creatinine clearance
b. Gastric pH
c. Plasma drug levels
d. Serum albumin
e. Serum creatinine

Answer 1

A, C, D
Creatinine clearance is the best way to evaluate renal function in the older adult. Plasma drug levels are important for determining if the patient has toxic or subtherapeutic drug levels. Serum albumin may be decreased, especially in patients who are thin, are chronically undernourished, or have been vomiting, and the decreased level may result in higher levels of drugs that normally bind to proteins. Gastric pH is not important; most GI changes result in lowered absorption and less free drug. Serum creatinine levels are related to the amount of lean muscle mass, which may be low in older adult patients, and do not reflect renal function.