Description

Overview

1. Creatinine
   1. Normal Value Range
   2. Pathophysiology
   3. Special considerations
   4. Elevations in creatinine
   5. Decreases in creatinine

Nursing Points

General

1. Normal values
   1. 0.7 – 1.4 mg/dL
2. Pathophysiology
   1. Muscle breakdown and use
      1. Creatine -> creatinine
   2. Released into bloodstream
      1. Filtered through kidneys
      2. Excreted in urine
   3. Creatinine more specific to kidney function
3. Special considerations
   1. Green top
   2. Submitted with renal panels or chems
   3. Creatinine clearance
      1. Tests creatinine in urine
      2. Compare to serum creatinine
      3. 24 hour urine
         1. Toss first urine sample, then start
         2. On ice
4. Increased creatinine values
   1. Renal disease
   2. Rhabdomyolysis
      1. Muscle breakdown
      2. Trauma
      3. Extreme workouts
   3. Congestive heart failure
   4. Dehydration
   5. Shock
5. Decreased creatinine values
   1. Loss of muscle mass
   2. Muscular dystrophy
   3. Decreased protein intake
   4. Pregnancy
   5. Liver disease

Assessment

1. Assess patient's nutritional status
2. Assess urine output
3. Consider other causes for increase in creatinine
   1. Muscle

Therapeutic Management

1. Treat cause of renal insufficiency
   1. Dialysis vs medication

Nursing Concepts

1. Lab Values
2. Elimination