Adult Critical Care Specialty (ACCS) Practice Exam

Elevated creatinine is a significant lab finding that typically suggests a decrease in renal function, particularly in contexts such as dehydration. When the body is dehydrated, blood flow to the kidneys can decrease, leading to an accumulation of metabolic waste products, one of which is creatinine. Since creatinine is a waste product from muscle metabolism and is usually filtered by healthy kidneys, an elevation indicates that the kidneys may not be functioning optimally. In cases of dehydration, elevated creatinine levels reflect the kidneys' struggle to clear waste from the bloodstream, thus highlighting the potential risk of impaired renal function. This situation can lead to acute kidney injury if not addressed promptly. Other options like elevated glucose, normal BUN, and normal sodium do not carry the same implication regarding renal issues linked to dehydration. Elevated glucose could suggest diabetes or stress but is not specifically indicative of renal insufficiency due to dehydration. Normal BUN coupled with elevated creatinine typically rules out significant renal impairment, while normal sodium does not directly indicate any renal dysfunction related to dehydration.