A nurse is reviewing the laboratory results of a client who has chronic kidney disease. Which of the following electrolytes should the nurse expect to be elevated in this client? (Select all that apply.)

Choice A reason:

Sodium is not likely to be elevated in a client who has chronic kidney disease because the kidneys tend to lose sodium along with water. Sodium levels may be low (hyponatremia) or normal in these clients, depending on their fluid status and dietary intake.

Choice B reason:

Potassium is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess potassium. Potassium levels may be high (hyperkalemia) or normal in these clients, depending on their medication use and dietary intake.

Choice C reason:

Calcium is not likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to activate vitamin D, which is needed for calcium absorption. Calcium levels may be low (hypocalcemia) or normal in these clients, depending on their parathyroid hormone levels and supplementation.

Choice D reason:

Phosphorus is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess phosphorus. Phosphorus levels may be high (hyperphosphatemia) or normal in these clients, depending on their dietary intake and phosphate binders.

Choice E reason:

Magnesium is likely to be elevated in a client who has chronic kidney disease because the kidneys are unable to excrete excess magnesium. Magnesium levels may be high (hypermagnesemia) or normal in these clients, depending on their dietary intake and antacid use.

Choice A reason:

This system helps to increase my blood pressure when it is too low. This is correct because the renin-angiotensin-aldosterone system (RAAS) is a mechanism that regulates arterial blood pressure by increasing sodium and water retention, vasoconstriction, and cardiac output.

Choice B reason:

This system helps to decrease my blood volume when it is too high. This is incorrect because the RAAS does the opposite of this. It increases blood volume by stimulating the secretion of aldosterone, which causes the kidneys to reabsorb sodium and water.

Choice C reason:

This system helps to regulate my blood pH when it is too acidic. This is incorrect because the RAAS does not directly affect blood pH. Blood pH is regulated by the respiratory and renal systems, which adjust the levels of carbon dioxide and bicarbonate in the blood.

Choice D reason:

This system helps to lower my potassium level when it is too high. This is incorrect because the RAAS does not directly lower potassium levels. Potassium levels are regulated by the kidneys, which excrete excess potassium in the urine. However, aldosterone, which is part of the RAAS, can indirectly affect potassium levels by increasing sodium reabsorption and potassium secretion in the distal tubules of the kidneys.