An older client has an elevated blood urea nitrogen (BUN) level, but the creatinine clearance is within normal limits. The nurse notes that the client's appetite has been poor the past few days. What should the nurse do about these laboratory findings?
1. Perform a daily weight and document.
2. Inform the physician of the BUN result.
3. Assess intake, output, and dietary intake of protein.
4. Monitor for increased medication levels.
3. Assess intake, output, and dietary intake of protein.
Explanation: 1. BUN can elevate in response to muscle breakdown and reduced mass, but a daily weight will not offer immediately useful information about the client's status.
2. Informing the physician is not necessary until further assessment data is collected.
3. The nurse should not rely on BUN levels as an indicator of renal function in the older person. BUN is affected by muscle mass, level of hydration, diagnosis of anemia, and dietary intake of protein. The nurse needs to further assess the client's intake and output and dietary intake of protein.
4. Because the creatinine clearance is within a normal range, it is unlikely that medication excretion will be affected. The nurse would bring this to the attention of the prescriber for consideration of dose changes in the event that other kidney function tests demonstrate declining clearance.
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