A nurse is caring for a client who reports to the clinic for laboratory tests. The client has an acute kidney injury caused by acute tubular necrosis and asks why their glomerular filtration rate (GFR) keeps decreasing. Which of the following pathophysiological changes occurring in the kidney should the nurse explain as the cause of the decrease?

Choice A reason: Air embolism is a potential complication during hemodialysis, but it would likely present with more acute symptoms such as chest pain or difficulty breathing.

Choice B reason: Septicemia would typically present with fever and hypotension, not necessarily with headache, nausea, and restlessness.

Choice C reason: Dialysis disequilibrium syndrome can occur after hemodialysis, especially after the first treatment, and is characterized by symptoms such as headache, nausea, and restlessness.

Choice D reason: Peritonitis is a complication associated with peritoneal dialysis, not hemodialysis.

Choice A rationale: Potassium is primarily excreted by the kidneys. While adequate renal function is necessary, the standard minimum urine output for adults is 30 mL/hour rather than 1 mL/kg/hour.

Choice B rationale: Low potassium levels (2.5 mEq/L) require long-term management. Educating the client on potassium-rich foods like bananas and potatoes helps prevent future depletion and supports overall electrolyte balance.

Choice C rationale: Severe hypokalemia and rapid IV replacement increase the risk of lethal cardiac dysrhythmias. Continuous ECG monitoring is vital to detect life-threatening changes in cardiac conduction and rhythm.

Choice D rationale: Following intravenous replacement, serum levels must be re-evaluated to confirm the effectiveness of the treatment and ensure the client does not develop iatrogenic hyperkalemia.

Choice E rationale: Dextrose stimulates insulin secretion, which causes an intracellular shift of potassium. This can lead to a further decrease in serum potassium levels, worsening the client's hypokalemia.