A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?
A.
Hypomagnesemia
B.
Hyperkalemia
C.
Decreased creatinine level
D.
Increased glomerular filtration rate (GFR)
The correct answer and Explanation is :
The correct answer is B. Hyperkalemia.
Explanation
In the oliguric phase of acute kidney injury (AKI), the kidneys fail to excrete adequate amounts of urine, which leads to various metabolic derangements. One of the significant changes seen during this phase is the accumulation of potassium in the blood, resulting in hyperkalemia.
- Oliguric Phase: This phase is characterized by a urine output of less than 400 mL per day. The kidneys are unable to filter blood effectively, leading to fluid retention and an imbalance of electrolytes.
- Electrolyte Imbalances: In AKI, especially during the oliguric phase, the retention of potassium is common. Normally, the kidneys help regulate potassium levels by excreting excess potassium in urine. When the kidneys are compromised, potassium builds up in the bloodstream, which can lead to serious complications such as cardiac arrhythmias.
- Other Options:
- A. Hypomagnesemia: While electrolyte imbalances do occur in AKI, hypomagnesemia is not a typical finding. In fact, magnesium levels may remain normal or even increase in some cases due to decreased excretion.
- C. Decreased creatinine level: During the oliguric phase, creatinine levels actually rise due to reduced renal clearance, not decrease.
- D. Increased glomerular filtration rate (GFR): In AKI, especially in the oliguric phase, GFR is typically decreased, not increased, due to impaired kidney function.
In summary, the oliguric phase of AKI is marked by hyperkalemia due to the kidneys’ inability to excrete potassium, making option B the correct choice. Monitoring potassium levels and managing hyperkalemia is crucial in the care of clients in this phase to prevent life-threatening complications.