A nurse is caring for a client who is in the diuresis phase of acute kidney injury. The nurse should closely monitor the client for what complication during this phase?

Hypocalcemia

Hypovolemia

Increased blood pressure

Hyperkalemia

Answer and Explanation

The Correct Answer is B

Choice A reason: Hypocalcemia may occur in AKI due to impaired vitamin D activation, but it is not a primary concern in the diuresis phase, where kidneys produce large urine volumes. Calcium imbalances are less immediate than fluid losses, which can rapidly destabilize hemodynamics during this phase.

Choice B reason: In the diuresis phase of AKI, kidneys regain function, producing excessive urine, which can lead to hypovolemia. Fluid loss depletes intravascular volume, causing hypotension, tachycardia, and organ hypoperfusion. Monitoring is critical to prevent dehydration and ensure adequate fluid replacement to maintain hemodynamic stability during recovery.

Choice C reason: Increased blood pressure is more common in the oliguric phase of AKI due to fluid overload. In the diuresis phase, excessive urine output reduces volume, potentially lowering blood pressure. Hypertension is not a typical complication during this phase, making it an incorrect focus for monitoring.

Choice D reason: Hyperkalemia is a concern in the oliguric phase of AKI due to reduced potassium excretion. In the diuresis phase, increased urine output facilitates potassium clearance, reducing hyperkalemia risk. Hypovolemia from excessive fluid loss is a more immediate concern during this phase of AKI recovery.

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Correct Answer is D

Explanation

Choice A reason: Left-sided flank pain may suggest kidney stones or infection but is not specific to AKI. Pain can occur in various conditions, including pyelonephritis or ureteral obstruction, and does not directly indicate reduced glomerular filtration or oliguria, which are hallmarks of AKI, making it less urgent.

Choice B reason: Blood pressure of 138/86 mm Hg and heart rate of 92 bpm are within normal ranges and not specific to AKI. While hypertension can occur in AKI due to fluid overload, these values do not strongly suggest AKI without other signs like oliguria or lab abnormalities.

Choice C reason: Cloudy urine with sediment and foul odor suggests a urinary tract infection, not necessarily AKI. Infections can coexist with AKI but are not diagnostic. AKI is characterized by reduced urine output and elevated creatinine, not primarily by urine appearance, making this finding less indicative.

Choice D reason: Urine output of 150 mL in 8 hours (450 mL/day) indicates oliguria, a key sign of AKI, where kidneys fail to filter adequately, reducing urine production. This can lead to fluid overload and toxin accumulation, necessitating urgent provider notification to evaluate and manage potential AKI complications like hyperkalemia.

A. Because your kidneys no longer produce urine, fluid can build up quickly and lead to complications like high blood pressure or difficulty breathing B. You should actually drink more fluids to stay hydrated since you’re not urinating C. As long as you’re attending all your dialysis sessions, your fluid intake doesn’t need to be restricted D. It’s not the fluids that are harmful, it’s the foods that are high in potassium and phosphorus

Correct Answer is A

Explanation

Choice A reason: In ESRD, anuria means no urine output, so excess fluid accumulates in the body, increasing intravascular volume. This can cause hypertension, pulmonary edema, and respiratory distress. Educating the client about these risks emphasizes the importance of fluid restrictions to prevent life-threatening complications between dialysis sessions, addressing their frustration accurately.

Choice B reason: Advising increased fluid intake is incorrect for anuric ESRD patients, as their kidneys cannot excrete fluid. This would exacerbate fluid overload, leading to hypertension, heart failure, or pulmonary edema. Hydration is managed through dialysis, not increased oral intake, which could overwhelm the body’s limited fluid-handling capacity.

Choice C reason: Stating that fluid intake is unrestricted with dialysis is incorrect. Even with regular dialysis, excessive fluid intake between sessions can lead to overload, causing hypertension or pulmonary edema. Dialysis removes a limited amount of fluid per session, requiring strict restrictions to maintain safe fluid balance and prevent complications.

Choice D reason: While potassium and phosphorus restrictions are critical in ESRD to prevent hyperkalemia and hyperphosphatemia, the client’s question focuses on fluid restrictions. This response does not address fluid overload risks like hypertension or pulmonary edema, which are direct consequences of excessive fluid intake in anuric patients, making it irrelevant to the query.

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A nurse is caring for a client who is in the diuresis phase of acute kidney injury. The nurse should closely monitor the client for what complication during this phase?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is A

Explanation

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