An 80-year-old woman was admitted with a diagnosis of hypertension, congestive heart failure, anemia, possible
diabetes, and chronic renal failure. She was treated with
diuretics and IV fluids and released 4 days later. Her
laboratory results are shown in Case Study Table.

Five months later, she was readmitted for treatment of repeated bouts
of dyspnea. She was placed on a special diet and medication to control
her hypertension and was discharged. Medical staff believed that she
had not been taking her medication as prescribed, and she was
counseled regarding the importance of regular doses.

Questions
1. What is the most probable cause of the patient’s elevated urea
nitrogen? Which data support your conclusion?

2. Note that this patient’s admitting diagnosis is “possible diabetes.” If
the patient had truly been diabetic, with an elevated blood glucose and
a positive acetone, what effect would this have had on the measured
values of creatinine? Explain.

Values is in the screenshot