Final answer:
A nurse assesses for metabolic acidosis in a child with acute kidney injury, as AKI can impair kidney function, leading to an accumulation of acids and potential acid-base imbalance.
Step-by-step explanation:
When a child has acute kidney injury (AKI), the primary acid-base balance that a nurse assesses the child for is the potential development of metabolic acidosis. The kidneys play a crucial role in regulating the body's acid-base balance by adjusting hydrogen ion levels and conserving bicarbonate, thus directly impacting the pH of blood. In AKI, there is a decline in renal function, which impairs the kidneys' ability to excrete hydrogen ions and conserve bicarbonate, potentially leading to an accumulation of acids in the body. As a result, the child is at a heightened risk of metabolic acidosis, where there is an excessive accumulation of acid or loss of bicarbonate.
To assess the child's acid-base status, a nurse would look at lab tests for pH, CO2 partial pressure (pCO2), and bicarbonate (HCO3) levels. These tests help identify whether the imbalance is due to a respiratory condition or a metabolic issue such as the renal impairment associated with AKI. Clinical evaluation may include examination of electrolyte levels, particularly sodium and potassium, which can be affected in AKI with implications for acid-base status.