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. Overhydration, hypoglycemia, and weight gain is incorrect because weight gain could indicate adequate or excessive caloric intake, and hypoglycemia may be related to other factors such as insulin administration rather than inadequate nutrition. Overhydration is more of a fluid balance issue than a direct indicator of nutrition goals not being met.

B. Hyperglycemia, normovolemia, and increased protein level is incorrect because increased protein levels suggest adequate protein intake. Normovolemia indicates proper fluid status, and while hyperglycemia can occur with parenteral nutrition, it does not alone indicate that nutritional goals are unmet.

C. Weight loss, elevated glucose, and dehydration is correct because weight loss reflects inadequate caloric intake, elevated glucose may indicate poor metabolic control or stress response to inadequate nutrition, and dehydration suggests insufficient fluid intake. These objective findings collectively indicate that nutrition and fluid goals are not being met, which could impair recovery and wound healing.

D. Weight gain, inconsistent glucose, and normovolemia is incorrect because weight gain and normovolemia indicate that at least caloric and fluid needs are partially met. Inconsistent glucose alone does not clearly indicate that nutritional goals are unmet without other signs such as weight loss or protein deficiency.

Rationale:
A. Administration of naloxone is incorrect because naloxone is an opioid antagonist used for opioid overdose, not for AMI. It has no role in managing myocardial ischemia.

B. Administration of aspirin is correct because aspirin inhibits platelet aggregation, reducing further clot formation in a coronary artery. Early administration of aspirin in suspected AMI improves outcomes and reduces mortality.

C. Oxygen therapy is correct because oxygen is given to increase oxygen delivery to ischemic myocardium, particularly in patients who are hypoxic, have dyspnea, or show signs of heart failure. Routine oxygen is reserved for patients with SpO₂ < 94%, per current guidelines.

D. Administration of morphine is correct because morphine relieves severe chest pain and reduces sympathetic stimulation, which can decrease myocardial oxygen demand. Morphine also helps alleviate anxiety associated with AMI.

E. Dopamine infusion is incorrect as a first-line intervention for AMI unless the patient has hemodynamic instability such as hypotension with poor perfusion. Dopamine is a vasopressor and inotrope, not routinely indicated for stable AMI management.

F. Administration of nitroglycerin is correct because nitroglycerin dilates coronary arteries, improving myocardial perfusion and reducing ischemic chest pain. It also reduces preload and myocardial oxygen demand. Care is needed in patients with hypotension or right ventricular infarction.