A patient with acute kidney injury is demonstrating signs of gastrointestinal bleeding. The nurse realizes that the reason for the onset of this bleeding is due to
1. increased ammonia level.
2. low creatinine level.
3. low calcium level.
4. elevated potassium level.
1
Rationale: Electrolyte imbalances and increasing levels of uremic toxins are the primary contributors to gastrointestinal manifestations. As urea decomposes in the gastrointestinal tract, it releases ammonia. Ammonia in the gastrointestinal tract increases capillary fragility and gastrointestinal mucosal irritation resulting in small mucosal ulcerations and the potential for pain, decreased appetite, and gastrointestinal bleeding. Gastrointestinal bleeding in the patient with an acute kidney injury is not due to low creatinine levels, low calcium levels, or elevated potassium levels.
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