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A patient's lab result shows Serum Creatinine level of 7mg%. The finding would lead the nurse to place highest priority on assessing -
Question

A patient's lab result shows Serum Creatinine level of 7mg%. The finding would lead the nurse to place highest priority on assessing -

A.

Temperature

B.

Intake and output

C.

Capillary refill time

D.

Pupillary reflex

Correct option is B


Ans. (b) Intake and output
Explanation:
A serum creatinine level of 7 mg/dL is significantly elevated, indicating severe renal impairment or kidney failure. Normal creatinine levels range from:
· 0.6 – 1.2 mg/dL (in adult males)
· 0.5 – 1.1 mg/dL (in adult females)
Since the kidneys regulate fluid balance and waste excretion, the highest priority is to assess intake and output (I&O) to monitor renal function and fluid retention.
Why is assessing Intake and Output (I&O) the priority?
· Severe kidney dysfunction leads to decreased urine output (oliguria/anuria).
· Fluid overload can cause hypertension, pulmonary edema, and heart failure.
· Monitoring I&O helps evaluate kidney function, fluid balance, and effectiveness of treatments (e.g., dialysis).
Why are the other options incorrect?
1. Temperature → (Incorrect Choice)
· Fever may indicate infection (e.g., urinary tract infection), but it is not the highest priority in acute renal failure.
2. Capillary Refill Time → (Incorrect Choice)
· Capillary refill assesses peripheral circulation, but in kidney failure, fluid overload is a bigger concern.
3. Pupillary Reflex → (Incorrect Choice)
· Neurological assessment is essential in uremic encephalopathy, but monitoring kidney function (I&O) takes precedence.

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