A nurse is caring for a client with acute kidney injury and metabolic acidosis. Which laboratory finding should the nurse expect?

Choice A reason: A pH of 7.30 indicates metabolic acidosis, common in acute kidney injury due to impaired acid excretion and bicarbonate reabsorption by damaged kidneys. This low pH reflects acid accumulation, risking systemic complications like cardiac dysfunction, requiring interventions like dialysis to correct the acid-base imbalance. Choice B reason: Serum bicarbonate of 30 mEq/L is elevated, indicating alkalosis, not acidosis. In acute kidney injury, bicarbonate levels are typically low (<22 mEq/L) due to reduced renal reabsorption, so this finding is inconsistent with the metabolic acidosis expected in AKI, making it incorrect. Choice C reason: Serum potassium of 3.2 mEq/L indicates hypokalemia, which is not typical in acute kidney injury. Hyperkalemia is more common due to impaired potassium excretion, so this low level does not align with AKI’s pathophysiology, where acidosis exacerbates potassium retention, not depletion. Choice D reason: Blood urea nitrogen of 10 mg/dL is normal and not expected in acute kidney injury, where BUN is elevated due to reduced renal clearance of urea. Metabolic acidosis accompanies elevated BUN, so this normal value is inconsistent with AKI’s typical laboratory profile.