A client with peritonitis develops acute kidney injury (AKI). Which nursing intervention is essential in the management of this complication?
A.
Monitoring blood glucose levels
B.
Administering pain medication as prescribed
C.
Encouraging fluid intake to 3 liters per day
D.
Maintaining fluid and electrolyte balance
The Correct Answer and Explanation is:
The correct answer is D. Maintaining fluid and electrolyte balance.
Explanation
Acute Kidney Injury (AKI) is a serious condition that can arise as a complication of peritonitis. AKI occurs when the kidneys suddenly fail to filter waste products from the blood effectively. This can be a result of several factors related to peritonitis, such as sepsis, hypovolemia, or direct kidney damage.
Maintaining fluid and electrolyte balance is crucial in managing AKI because it helps prevent further deterioration of kidney function and supports overall physiological stability. Here’s why this intervention is essential:
- Fluid Management: In AKI, there is often a disturbance in fluid balance due to impaired kidney function. Patients may experience either fluid overload or dehydration. Proper fluid management involves careful monitoring of intake and output, as well as regular assessments of fluid status (e.g., daily weights, edema). Administering intravenous fluids may be necessary to address hypovolemia, but it must be done cautiously to avoid fluid overload, which can exacerbate kidney injury.
- Electrolyte Balance: The kidneys are crucial for regulating electrolyte levels, including sodium, potassium, and calcium. In AKI, the kidneys may struggle to excrete excess electrolytes or reabsorb necessary ones. This can lead to imbalances that can cause severe complications like hyperkalemia (elevated potassium levels) or hypocalcemia (low calcium levels). Regular monitoring of electrolyte levels and timely correction of imbalances through medications or adjustments in fluid therapy is essential to prevent complications.
- Preventing Complications: Proper fluid and electrolyte management helps to prevent complications associated with AKI, such as metabolic acidosis, which can occur when the kidneys fail to excrete acids. It also supports the cardiovascular system, as fluid overload can strain the heart, while dehydration can decrease blood pressure and perfusion to vital organs.
In contrast, while monitoring blood glucose levels (A) is important for diabetic management, it is not directly related to AKI management. Administering pain medication (B) can help alleviate discomfort but does not address the underlying fluid and electrolyte imbalances. Encouraging fluid intake to 3 liters per day (C) might not be appropriate as it depends on the patient’s current fluid status and kidney function.
In summary, maintaining fluid and electrolyte balance is essential in the management of AKI as it addresses the core issues related to impaired kidney function and supports the patient’s overall stability.