National League for Nursing (NLN) Medication Practice Exam

An increased serum creatinine level is a significant indicator of renal toxicity, particularly in patients receiving vancomycin hydrochloride. This is because vancomycin is known to potentially cause nephrotoxicity, especially when used at higher doses or in patients with pre-existing renal impairment.

Creatinine is a waste product that is normally filtered out of the blood by the kidneys. When kidney function is compromised, the serum creatinine levels rise, reflecting deteriorating renal function. Monitoring this parameter is crucial in patients on nephrotoxic medications like vancomycin to assess kidney health and make necessary dose adjustments or discontinuation of the drug to prevent further damage.

Other options do not typically indicate renal toxicity. For instance, a decreased BUN level might suggest improved renal function or could be influenced by factors unrelated to renal toxicity. Increased blood pressure and intermittent flank pain are not directly associated with the renal toxicity caused by vancomycin and may arise from other issues unrelated to renal function.