The nurse is reviewing labs of a newly admitted client. Which lab result would prompt the nurse to contact the health care provider?

  1. ALT 33 units/L
  2. BNP 760 pg/mL
  3. WBC 10,450 mcL
  4. direct bilirubin 0.2 mg/dL
Number 2 is correct.
Rationale: BNP, or B-type natriuretic peptide, is a hormone released by the heart in response to pressure changes within the heart. It is used to gauge the severity of congestive heart failure. A normal range in a client with heart failure is 0 to 100 pg/mL. A BNP of 760 pg/mL indicates severe heart failure. ALT (alanine aminotransferase) tests liver enzymes. The normal range of ALT is 7 – 56 units per liter, so a value of 33 units/L is within normal limits. WBC (white blood cell) count normally ranges from 4,500 to 11,000 mcL, so a value of 10,450 is within normal limits. Direct bilirubin is a by-product of RBC breakdown. Normal lab values for direct bilirubin range from 0 to 0.3 mg/dL, so a value of 0.2 mg/dL falls within normal limits.