The nurse is caring for a client who is in the oliguric phase of an acute kidney injury. Which of the following electrolyte imbalances would be consistent with this condition?

Choice A reason: In the oliguric phase of acute kidney injury, reduced urine output leads to fluid retention, diluting serum sodium (hyponatremia), and impaired potassium excretion causes hyperkalemia. These imbalances reflect the kidneys’ inability to regulate electrolytes, risking cardiac arrhythmias and fluid overload, consistent with AKI’s pathophysiology. Choice B reason: Hypernatremia and hypokalemia are not typical in oliguric acute kidney injury. Hypernatremia occurs with dehydration, not fluid retention, and hypokalemia is uncommon, as AKI causes potassium retention. These imbalances are more associated with conditions like diabetes insipidus or diuretic overuse, not AKI. Choice C reason: Hypernatremia is unlikely in oliguric acute kidney injury, as fluid retention dilutes sodium. Hyperkalemia is expected due to reduced potassium excretion, but the combination with hypernatremia is inconsistent, as AKI typically causes hyponatremia from water retention, making this choice incorrect. Choice D reason: Hyponatremia may occur in oliguric AKI due to fluid retention, but hypokalemia is not typical, as impaired renal excretion leads to hyperkalemia. This combination is inconsistent with AKI’s pathophysiology, where potassium accumulation and sodium dilution are more common due to reduced kidney function.