Question

While caring for the patient in the oliguric phase of AKI, the nurse monitors the patient for associated collaborative problems. When should the nurse notify the health care provider?

a. Urine output is 300 mL/day.
b. Edema occurs in the feet, legs, and sacral area.
c. Cardiac monitor reveals a depressed T wave and elevated ST segment.
d. The patient experiences increasing muscle weakness and abdominal cramping.

Answer 1

In the oliguric phase of AKI, the nurse must notify the health care provider if significant changes occur, especially cardiac monitor changes indicating hyperkalemia and symptoms like increasing muscle weakness and abdominal cramping that could signify severe electrolyte imbalances.

Step-by-step explanation:

While caring for a patient in the oliguric phase of acute kidney injury (AKI), a nurse should monitor for signs that indicate worsening of the patient's condition or potential life-threatening complications. The nurse should notify the health care provider immediately if the patient experiences any of the following:

• A urine output of 300 mL/day could be indicative of oliguria and worsening renal function, which is a concern.
• Edema in the feet, legs, and sacral area signals fluid retention and worsening kidney function but may not require immediate notification depending on the patient's overall status and treatment plan.
• Cardiac monitor changes such as a depressed T wave and elevated ST segment are indicative of hyperkalemia, a potentially life-threatening condition that can lead to cardiac arrhythmias, necessitating immediate medical attention.
• Increasing muscle weakness and abdominal cramping could also be a sign of electrolyte imbalances, such as hyperkalemia or hypocalcemia, which are emergent situations.

AKI is characterized by a rapid decline in kidney function, leading to disturbances in fluid and electrolyte balance, and potential complications like heart arrhythmias and muscle weakness due to electrolyte imbalances.