Final answer:
The patient should have additional blood tests for potential infection, renal function, and calcium levels, as well as a urinalysis for abnormal protein levels. These tests are vital for assessing kidney health and may indicate serious underlying conditions like multiple myeloma.
Step-by-step explanation:
The patient with symptoms of back pain, normocytic anemia, elevated total protein levels, and worsening kidney function may potentially have a serious underlying condition. The combination of these symptoms could suggest multiple myeloma, a type of blood cancer that affects plasma cells in the bone marrow, or other kidney-related issues such as nephrotic syndrome. It is critical to order additional blood tests to check for a raised white cell count which may suggest an infection, abnormal renal function tests, and to look for high blood calcium levels (hypercalcaemia) which is often associated with multiple myeloma. In addition, a urinalysis can be helpful to look for abnormal protein levels such as proteinuria, which is an important indicator of kidney health. The complete evaluation should be performed under the guidance of a healthcare professional capable of interpreting the results and suggesting further diagnostic testing such as bone marrow biopsy if multiple myeloma is suspected.