Question

The client has an order for gentamycin to be administered. Which lab results should be reported to the doctor before beginning the medication? A. Hematocrit B. Creatinine C. White blood cell count D. Erythrocyte count

Short answer

Answer: B. Creatinine

Step-by-step solution

Analyze the given options (A, B, C, D)

We need to identify which lab result is directly related to kidney function. Let's analyze each available answer. A. Hematocrit: Hematocrit is the volume percentage of red blood cells in blood. It is a measure of the blood's ability to carry oxygen but is not directly related to kidney function. B. Creatinine: Creatinine is a waste product that is filtered by the kidneys and excreted in the urine. Higher levels of creatinine can be a sign of impaired kidney function, making it a relevant measure for kidney function. C. White blood cell count: White blood cell count indicates the number of white blood cells in a person's blood and assesses the body's ability to fight infections. It is not directly related to kidney function. D. Erythrocyte count: Erythrocyte count is the number of red blood cells in the blood, involved in oxygen transport. It is not directly related to kidney function. From the analysis, option B (Creatinine) is the test result directly related to kidney function.

Choose the correct answer

Based on the understanding of the different lab results and their relation to kidney function, the correct answer is: B. Creatinine As it is the test result that reflects kidney function which must be assessed before administering gentamycin to avoid potential kidney damage.

Key concepts

Creatinine Levels

Understanding creatinine levels is crucial when it comes to gauging kidney health. Creatinine is a waste product formed from muscle metabolism, which healthy kidneys filter out and excrete via urine.

For adults, normal creatinine levels are typically between 0.6 to 1.2 milligrams per deciliter (mg/dL) for males, and 0.5 to 1.1 mg/dL for females. However, these values can vary based on age, gender, and body size. Significantly elevated creatinine levels could indicate kidney impairment or disease, often necessitating prompt medical attention.

Medications like gentamycin can have nephrotoxic effects, meaning they can damage the kidneys. Hence, measuring creatinine levels before administering such medications is essential to ensure that the kidneys are functioning well enough to handle the extra workload and to prevent further damage.

Kidney Function Tests

In the realm of kidney function tests, healthcare providers rely on several assessments to evaluate renal performance. The primary tests include serum creatinine, blood urea nitrogen (BUN), and estimated glomerular filtration rate (eGFR).

The eGFR is calculated from the serum creatinine level, age, race, and gender, and it estimates how well the kidneys filter waste from the blood. An eGFR below 60 mL/min/1.73 m² for three months or longer usually indicates chronic kidney disease. BUN, another important measure, assesses the amount of urea nitrogen, a byproduct of protein metabolism, in the blood.

Regular monitoring of these tests helps detect kidney dysfunction early, allowing for timely interventions. For individuals with compromised kidney function, close monitoring is key when introducing new medications that could potentially exert a higher filtration demand on the kidneys or have direct toxic effects on renal tissue.

Pharmacology Nursing

In pharmacology nursing, nurses must understand the mechanisms, uses, side effects, and potential toxicities of medications. It is part of their role to know how drugs interact with the body and how the body responds, particularly the kidneys which play a significant role in filtering and excreting drugs.

Nephrotoxicity is a concern with certain drugs like aminoglycosides (e.g., gentamycin), NSAIDs, and ACE inhibitors. Nurses must be vigilant when administering such drugs and advocate for preemptive kidney function testing.

Emphasizing the importance of patient education about the implications of drug therapy, particularly regarding the signs of kidney dysfunction, is a part of safe medication administration. Nurses must also be prepared to act upon abnormal lab results, such as elevated creatinine levels, by alerting the prescribing physician and potentially withholding the medication until further assessments are made.