The nurse is caring for a client with blood loss from esophageal varices. Which assessment finding indicates that the client is exhibiting signs of acute kidney injury (AKI) related to the loss of volume?

A. An inability to initiate voiding may indicate urinary retention or obstruction, but it is not a primary sign of AKI. B. Acute flank pain suggests renal colic or obstruction, not volume-related AKI. C. Cloudy urine with a foul odor indicates infection but not necessarily AKI. D. Urine output of 0.5 mL/kg/hr or less for several hours indicates decreased kidney perfusion and is an early sign of AKI related to hypovolemia from blood loss.