A client with end-stage renal disease (ESRD) is experiencing severe fatigue, weakness, and decreased urine output. Laboratory tests show elevated levels of blood urea nitrogen (BUN) and creatinine. Which of the following is the primary indication for initiating dialysis in this client?

A) This statement is incorrect. Administering an analgesic for the abdominal pain may provide temporary relief, but it does not address the underlying cause of the symptoms.

B) This statement is incorrect. Measuring blood pressure and pulse rate is essential for client assessment, but it may not provide enough information to determine the cause of the symptoms.

C) This statement is accurate. Abdominal pain and fever in a client on peritoneal dialysis may indicate peritonitis, which can result from infection or catheter issues. The nurse should first check the catheter for kinks or obstructions to ensure proper drainage and prevent complications.

D) This statement is incorrect. Notifying the healthcare provider about the symptoms is important, but the nurse should first assess the catheter for possible issues to determine if immediate intervention is needed.

A) This statement is incorrect. Hypokalemia (low potassium levels) is not an indication for initiating dialysis. In AKI, electrolyte imbalances can occur, but hyperkalemia is more likely due to impaired kidney function.

B) This statement is incorrect. Hyponatremia (low sodium levels) is not a primary indication for initiating dialysis in AKI. It can occur due to fluid shifts, but the primary concern in AKI is the accumulation of waste products like urea, leading to uremia.

C) This statement is incorrect. Hypernatremia (high sodium levels) is not a primary indication for initiating dialysis in AKI. Hypernatremia is rare in AKI and usually occurs when there is a significant loss of free water compared to sodium intake.

D) Uremia, which is characterized by elevated levels of urea and other waste products in the blood, is a critical indication for initiating dialysis in clients with acute kidney injury. Dialysis helps remove these toxic substances from the bloodstream.