The nurse is reviewing laboratory data for a patient scheduled for an intravenous pyelogram. Which result should the nurse report to the primary healthcare provider immediately?
1. serum osmolality of 1500 mOsm/kg/H2O
2. serum creatinine of 1.30 mg/dL
3. blood urea nitrogen of 20 mg/dL
4. hourly urine output of 45 mL/hour
Correct Answer: 1
Prior to the IVP the nurse should assess renal and fluid status, including serum osmolality, creatinine, and blood urea nitrogen (BUN) levels. Notify the physician of any abnormal values. This patient's serum osmolality is elevated. Normal findings are 50?1200 mOsm/kg/H2O. Elevated serum osmolality may indicate a high-protein diet, SIADH, Addison disease, dehydration, or hyperglycemia. The creatinine, BUN, and hourly urine output findings are within normal limits for this patient.
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