Final Answer:
The precipitating factors that may contribute to AKI in this patient are Age-related physiologic changes, Chronic systemic disease and NPO status. Thus, the correct answer is options C) Age-related physiologic changes, D) Chronic systemic disease, E) NPO status.
Step-by-step explanation:
As individuals age, there are natural physiologic changes that occur in the kidneys. The renal blood flow decreases, and the number of functional nephrons declines. These age-related changes can compromise the kidney's ability to effectively filter and excrete waste products, potentially contributing to acute kidney injury (AKI).
Chronic systemic diseases, such as cancer, can further stress the kidneys. The malignancy itself and the treatments, including chemotherapy, may lead to renal complications. In this case, the patient has been diagnosed with cancer and has undergone chemotherapy, making her more susceptible to AKI due to the impact on renal function.
The NPO (nothing by mouth) status, which is often required before surgery, can contribute to dehydration. Dehydration reduces renal blood flow and may lead to prerenal causes of AKI. In an elderly patient, especially one with age-related physiologic changes and chronic systemic disease, maintaining adequate hydration is crucial to prevent renal complications during the perioperative period.
In summary, the combination of age-related physiologic changes, chronic systemic disease (cancer), and NPO status places the elderly woman at an increased risk of developing acute kidney injury. These factors underscore the importance of vigilant monitoring and proactive measures to preserve renal function in this vulnerable population, especially during cancer treatment and surgery. Therefore, the correct answer is options C) Age-related physiologic changes, D) Chronic systemic disease, E) NPO status.