Question

A 76 year-old hospitalized patient is about to begin chemotherapy for colon cancer. The medications to be given are known to be toxic to multiple organs.

The patient's lab values are notable for the following:

Hct: 32.2%                           (Normal: 38.8 - 50.0%)

Hgb: 11 g/dL    (Normal: 13.5 - 17.5 g/dL)

WBCs: 8,800 cells/cc (Normal: 3,500 - 10,000 cells/cc)

Platelets: 155,000 cells/cc (Normal: 150,000 - 450,000 cells/cc)

Complete Metabolic Panel:

Ast: 34 IU/L (Normal: 10 -34 IU/L)

Alt: 30 IU/L    (Normal: 7 -40 IU/L)

BUN: 24 mg/dL             (Normal: 6 - 20 mg/dL)

Creatinine: 1.7 mg/dL   (Normal: 0.6 - 1.3 mg/dL)

Which follow up laboratory test result would the nurse like to see before administering the medication?

Question options:

a)	repeat serum creatinine

b)	liver biopsy

c)	repeat complete blood count

d)	creatinine clearance

e)	urinalysis

Answer 1

The level of serum creatinine is elevated which means there is some renal dysfunction which can affect the drug clearance after administering the chemotherapy medications so it will be better to do a creatinine clearance levels and take appropriate preventative measures .The risk of renal impairment is high in chemotherapy drugs administration

The liver biopsy is not needed as the liver enzymes are withing normal limits

The hemoglobin and hematocrit levels are decreased whereas the wbc and platelets are in normal range so need to be repeated and checked about the current status before chemotherapy if abnormal

Urinanalysis is required as the BUN ,creatinine levels are increased to know the kidney function before initiating chemotherapy

Ans: Urinanalysis