The nurse understands that the most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply)

Rationale: A. Hypokalemia is incorrect because dialysis is not initiated for low potassium levels. In fact, dialysis can further lower potassium and worsen hypokalemia. Dialysis is indicated for dangerously high potassium levels that are unresponsive to medical management. B. Volume overload is correct because impaired kidney function leads to fluid retention, which can cause pulmonary edema, hypertension, and heart failure. Dialysis removes excess fluid when diuretics are ineffective or contraindicated. C. Uremia is correct because accumulation of nitrogenous waste products (such as urea and creatinine) can cause symptoms like altered mental status, pericarditis, nausea, vomiting, and bleeding. Dialysis removes these toxins from the blood. D. Hyperkalemia is correct because elevated potassium levels can cause life-threatening cardiac dysrhythmias. Dialysis rapidly lowers serum potassium when medical treatment is insufficient or when potassium levels are critically high. E. Acidosis is correct because severe metabolic acidosis occurs when the kidneys cannot excrete hydrogen ions or regenerate bicarbonate. Dialysis helps correct acid–base imbalance when acidosis is refractory to other treatments.