The nurse cares for an admitted client to rule out a multiple myeloma diagnosis. Which finding does the nurse report to the healthcare provider immediately?
1. Positive Bence Jones protein
2. Bone pain in the lower ribs
3. Hemoglobin level is decreased to 11 g/dL
4. Blood Urea Nitrogen changed from 20 mg/dL to 48 mg/dL
4. Blood Urea Nitrogen changed from 20 mg/dL to 48 mg/dL
Explanation: 1. In the client with suspected multiple myeloma, this is a finding the provider will look for and does not need to be reported.
2. Bone pain is a typical presentation for the client with multiple myeloma. This is not an urgent finding unless it is uncontrolled pain.
3. Anemia is common in multiple myeloma and this is not a significantly low level. If this represents a significant difference from the previous value, the provider should be made aware when visiting the client.
4. Renal failure is a serious complication of multiple myeloma and must be treated aggressively. Initially, fluids and diuretics may be used. Dialysis may be required later.
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