A nurse cares for a client with an increased blood urea nitrogen (BUN)/creatinine ratio. Which action should the nurse take first?
a. Assess the client's dietary habits.
b. Inquire about the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
c. Hold the client's metformin (Glucophage).
d. Contact the health care provider immediately.
ANS: A
An elevated BUN/creatinine ratio is often indicative of dehydration, urinary obstruction, catabolism, or a high-protein diet. The nurse should inquire about the client's dietary habits. Kidney damage related to NSAID use most likely would manifest with elevations in both BUN and creatinine, but no change in the ratio. The nurse should obtain more assessment data before holding any medications or contacting the provider.
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