BUN elevation

  1. OK..

    I have been racking my brain for hours over this..

    My pt is in the hospital with a possible small bowel obstruction.. She has had N/V for the past day or two...

    Her BUN is slightly elevated.. But I can't figure out why?? Is it possible b/c of the N/V has dehydrated her some??

    Any hints would be great..
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  2. 6 Comments

  3. by   hoolahan
    Yes, it is possible, and even likely, that is the reason. Other ways to check for dehydration in labs, are elevated Hematocrit, elevated serum and urine osmo.

    I think that GI bleding can also cause an elevated BUN, but for the life of me I can't remember why off the top of my head. I'm sure some other younger whippersnapper will pop in and tell you the why of that.
  4. by   CelticNurse
    Hello there,

    Without knowing more about your patient (and I'm not going to ask for a full history!), it can be a bit of a stab in the dark, but you are on the right lines. Dehydration can be a cause of elevated electrolytes, indeed. There are, however, other aspects that can add to the problem....

    Not knowing the vitals of the lady in question it is hard, but another differential diagnosis is an underlying source of sepsis intra-abdominally. Admittedly, this is a more 'worst-case-scenario' type of direction, but it is not to be overlooked. Speaking as an ITU nurse, I tend to more towards the grimmer end of possibilities on occasions but I make no apologies for such an approoach. I work on the basis that it is better to hope for the best whilst simultaneously expecting the worst! It keeps you on top of your game.

    Hope you get to the nub of your problem. Don't worry, it'll all come good.....
  5. by   ageless
    GI bleeders can have higher than normal BUN levels because blood proteins (nitrogen) are digested.
  6. by   hoolahan
    Thanks ageless!
  7. by   ageless
    PS. wish I could say I was a young whippersnapper!
  8. by   Ortho_RN
    Thank you all very much..

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