Which laboratory value should the nurse report to the healthcare provider first?

When evaluating which laboratory value should be reported to the healthcare provider first, it is essential to consider the severity and potential consequences of each condition indicated by the values.

A creatine kinase level of 30,000 U/L is significantly elevated, particularly in the context of a cocaine overdose, which can lead to life-threatening complications. Elevated creatine kinase is often associated with rhabdomyolysis, a serious condition where muscle breakdown occurs, releasing toxic substances into the bloodstream that can lead to acute kidney injury and other systemic issues. The extremely high level of creatine kinase indicates a pressing situation that requires immediate medical intervention, particularly because it suggests severe muscle damage that could have acute effects on organ function.

In contrast, while the other laboratory values indicate concerning issues, they do not pose an immediate threat to the patient's well-being to the same extent. For example, a WBC count of 12,000/mm³ is not typically alarming in a postoperative client, as mild elevations can occur due to stress from surgery. Creatinine levels of 3.6 mg/dL are significant, especially in the context of end-stage renal disease, but the patient may already be receiving treatment for this condition. Finally, a BNP level of 600 pg/mL