Question

A patient's lab report shows slightly elevated total white blood cell count with equal elevations of all types of white blood cells, an elevated hemoglobin and hematocrit, normal creatine but elevated blood urea nitrogen (BUN) increased urine Specific gravity and increased serum sodium. The most likely nursing diagnoses is?

1) Risk of infection
2) Deficient fluid volume
3) Excess fluid volume
4) Imbalanced nutrition

Answer 1

The patient's lab findings, including elevated white blood cell count, increased hemoglobin, hematocrit, and BUN, alongside increased serum sodium, suggest dehydration, pointing to a nursing diagnosis of Deficient fluid volume.

Step-by-step explanation:

A patient with a slightly elevated total white blood cell (WBC) count, increased hemoglobin and hematocrit, normal creatinine but high blood urea nitrogen (BUN), increased urine specific gravity, and increased serum sodium is likely experiencing dehydration. Elevated hemoglobin and hematocrit can be indicative of polycythemia, which might temporarily occur due to dehydration. High BUN with normal creatinine suggests a pre-renal cause like decreased blood volume leading to concentrated urine and elevated serum sodium due to reduced fluid intake or excessive fluid loss.

Considering these lab findings, the most appropriate nursing diagnosis from the given options is (2) Deficient fluid volume. This is supported by the laboratory results indicating hemoconcentration and dehydration, rather than an infection, excess fluid volume, or imbalanced nutrition.