What is the most likely cause of the patient's elevated urea nitrogen? Which data support your conclusion?

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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What is the most likely cause of the patient's elevated urea nitrogen? Which data support your conclusion?

LABORATORY RESULTS-FIRST ADMISSION
Test
5/31
6/3
6/7
Urea N (mg/dL)
45
24
11
Creatinine (mg/dL)
1.8
1.3
0.9
Urea N/creatinine
25
18.5
12.2
pH
7.22
7.50
PCO2 (mm Hg)
74.4
48.7
pO2 (mm Hg)
32.8
57.6
O, sat (%)
51.3
91.0
Because of severe respiratory distress, the patient
was transferred to the intensive care unit, placed on
a respirator, and given diuretics and intravenous (IV)
fluids to promote diuresis. This treatment brought
about a significant improvement in both cardiac
output and renal function, as shown by laboratory
results several days later (6/3). After two additional
days on a respirator with IV therapy, the patient's
renal function had returned to normal and, at
discharge, his laboratory results were within normal
limits (6/7).
The patient was readmitted 6 months later
because of the increasing inability of his family to
arouse him. On admission, he was shown to have a
tremendously enlarged heart with severe pulmonary
disease, heart failure, and probable renal failure.
Laboratory studies on admission were as shown in
Case Study Table 12-1.2. Numerous attempts were
made to improve the patient's cardiac and pulmo-
nary function, all to no avail, and the patient died
4 days later.
Transcribed Image Text:LABORATORY RESULTS-FIRST ADMISSION Test 5/31 6/3 6/7 Urea N (mg/dL) 45 24 11 Creatinine (mg/dL) 1.8 1.3 0.9 Urea N/creatinine 25 18.5 12.2 pH 7.22 7.50 PCO2 (mm Hg) 74.4 48.7 pO2 (mm Hg) 32.8 57.6 O, sat (%) 51.3 91.0 Because of severe respiratory distress, the patient was transferred to the intensive care unit, placed on a respirator, and given diuretics and intravenous (IV) fluids to promote diuresis. This treatment brought about a significant improvement in both cardiac output and renal function, as shown by laboratory results several days later (6/3). After two additional days on a respirator with IV therapy, the patient's renal function had returned to normal and, at discharge, his laboratory results were within normal limits (6/7). The patient was readmitted 6 months later because of the increasing inability of his family to arouse him. On admission, he was shown to have a tremendously enlarged heart with severe pulmonary disease, heart failure, and probable renal failure. Laboratory studies on admission were as shown in Case Study Table 12-1.2. Numerous attempts were made to improve the patient's cardiac and pulmo- nary function, all to no avail, and the patient died 4 days later.
LABORATORY RESULTS-SECOND
ADMISSION
Urea N (mg/dL)
90
Creatinine (mg/dL)
Uric acid (mg/dL)
3.9
12.0
Urea N/creatinine
23
pH
7.35
pCO, (mm Hg)
pO2 (mm Hg)
Oz sat (%)
59.9
34.6
63.7
Transcribed Image Text:LABORATORY RESULTS-SECOND ADMISSION Urea N (mg/dL) 90 Creatinine (mg/dL) Uric acid (mg/dL) 3.9 12.0 Urea N/creatinine 23 pH 7.35 pCO, (mm Hg) pO2 (mm Hg) Oz sat (%) 59.9 34.6 63.7
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