A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury. Which of the following findings should the nurse identify as indicating an increased risk of acute kidney injury (AKI)?

Rationale: A. Although at the upper limit of normal (10–20 mg/dL), BUN alone is not a definitive indicator of AKI. It can be temporarily elevated due to dehydration, high-protein intake, or catabolic states, and must be interpreted alongside creatinine and other clinical findings. B. This value is within the normal adult range (1.5–2.5 mEq/L). Magnesium levels generally remain stable until more significant kidney dysfunction occurs, so this does not indicate increased AKI risk. C. This is within the normal range (3.5–5.0 mEq/L). While potassium imbalances can develop in AKI due to impaired excretion, a normal value does not reflect kidney injury. D. This is elevated above the normal range for adult females (0.6–1.3 mg/dL) and reflects impaired kidney function. After a myocardial infarction, decreased cardiac output can reduce renal perfusion, placing the client at high risk for acute kidney injury. An elevated creatinine in this context warrants close monitoring, potential adjustments to medications, and prompt interventions to prevent further renal damage.