Further Diagnostic Evaluation – High Level BUN (Nursing)

00:00 Okay so why are we looking at even more lab work? Well I know you know the answer to that question because one piece of information does not a diagnosis make.

00:10 So these are the other pieces of lab work that are really helpful to determine what is the cause of this elevated BUN.

00:17 Now the gold standard will be a 24-hour urine sample.

00:21 Yeah, nobody really likes doing those, we do them but they have a high risk for getting messed up because it's very specific about timing and making sure everything that patient puts out in a 24-hour period ends up in the right jug.

00:36 So we use a kind of an estimate that's why you see the EGFR, that's the estimated glomerulofiltration rate.

00:44 Great so that's a good indication of how things are moving through the filter, right? those working units of the kidneys,the glomerulus.

00:52 That's a mouthful.

00:53 Next, creatinine or creatinine clearance.

00:56 Now why would I pick one over the other.

00:59 Well creatinine clearance is specific, it's a better task for patients who are aging or elderly.

01:05 Sadly as we age, and I'm speaking personally, your fat level goes up and your muscle level goes down unless you're really intensive about taking care of that problem.

01:15 So what you want to do is make sure if you have an elderly client if you can, get a creatinine clearance versus a creatinine test.

01:23 Now albuminuria, that's a big word to say but it means albumin in your urine, protein in your urine.

01:31 That does require a 24-hour test to really get a good testing on it.

01:36 The reason that's a problem is because protein shouldn't make it through to your urine.

01:40 That indicates that the kidney is having problems.

01:43 An even better example is the albumin to creatinine ratio.

01:47 We'll talk about that in another video.