The nurse is caring for a client in acute kidney injury (AKI). Which complication would most clearly warrant the administration of polystyrene sulfonate?

Choice A reason: Stating that a colostomy is temporary might provide false hope if the status is uncertain, and it does not help the patient cope with their current reality. To improve body image, the patient must process their feelings about their current physical state rather than simply waiting for it to change.

Choice B reason: While education is helpful, unguided online research can expose the patient to graphic images or misinformation that may actually worsen anxiety and negative body image. The nurse should provide curated resources rather than encouraging broad, unsupervised internet searches during the initial period of psychological adjustment.

Choice C reason: Logic and "rationalizing" why the surgery was necessary (e.g., to treat cancer) often fails to address the emotional trauma of body disfigurement. A patient can be grateful to be alive while still feeling devastated by the presence of a stoma; the nurse must address the latter directly.

Choice D reason: Open dialogue allows the patient to express fears, grief, and concerns about intimacy, clothing, and social life. This therapeutic communication helps the nurse identify specific misconceptions and facilitates the patient's transition toward acceptance by validating their feelings and encouraging a realistic integration of the stoma into their self-concept.

Choice A reason: Joint pain (arthralgia) is a common extraintestinal manifestation of Crohn's disease and can also be a side effect of biologic therapy. While uncomfortable and worth noting, it is not typically an acute life-threatening emergency. It does not carry the same immediate clinical urgency as a sign of systemic infection in an immunocompromised patient.

Choice B reason: Infliximab is a tumor necrosis factor (TNF) inhibitor that significantly suppresses the immune system. Patients taking biologics are at high risk for serious opportunistic infections, including tuberculosis and sepsis. A fever may be the only early sign of a life-threatening infection, requiring immediate cessation of the drug and medical evaluation.

Choice C reason: Headache is a frequently reported side effect of infliximab infusions. While it should be monitored, it is generally considered a minor adverse effect unless it is exceptionally severe or accompanied by neurological deficits. It does not indicate the high level of physiological risk that a fever does in an immunosuppressed individual.

Choice D reason: Nausea is another common side effect associated with many medications, including biologics for inflammatory bowel disease. While it affects the client's quality of life and nutritional status, it is not an indicator of an acute, high-priority safety concern like a potential systemic infection or a severe hypersensitivity reaction.