A client who has low back pain reports that they are unable to void. The nurse notices a distended bladder on assessment. Which of the following is the likely cause of this client's low back pain?

Choice A reason: The normal range for serum creatinine in adult females is approximately 0.6–1.1 mg/dL. A level of 1.8 mg/dL is elevated and indicates impaired kidney function, which is a risk factor for AKI.

Choice B reason: Normal BUN levels are generally between 6 to 24 mg/dL⁸. A BUN level of 200 mg/dL is significantly elevated and suggests kidney dysfunction, which can lead to AKI.

Choice C reason: Serum osmolality in the normal range, which is typically between 275 to 295 mOsm/kg H2O for adults⁹[13][^10^][14][16], does not indicate an increased risk of AKI.

Choice D reason: The normal range for serum magnesium is typically 1.7 to 2.2 mg/dL or 0.85 to 1.10 mmol/L. A level of 2.0 mEq/L (which is equivalent to 2.0 mg/dL) is within the normal range and does not indicate an increased risk for AKI.

Choice A reason: Warming the dialysate in a microwave oven is not recommended because uneven heating could occur, leading to hot spots that can burn the peritoneal cavity. The dialysate should be warmed to body temperature using a warming device designed for this purpose.

Choice B reason: While some discomfort may be experienced during the first few exchanges, significant pain is not expected. If pain occurs, it should be reported to a healthcare provider, as it may indicate an underlying problem.

Choice C reason: Redness at the catheter exit site is not a normal expectation and could indicate an infection. The site should be kept clean and dry, and any signs of redness, swelling, or discharge should be reported to a healthcare provider immediately.

Choice D reason: There is no need to avoid foods high in fiber unless otherwise advised by a healthcare provider. In fact, a diet high in fiber can be beneficial for bowel regularity, which is important for patients on peritoneal dialysis.