Questions: A nurse is caring for a client who is in the oliguric-anuric stage of acute kidney injury. The client reports diarrhea, a dull headache, palpitations, and muscle tingling and weakness. Which of the following actions should the nurse take first? Administer an analgesic to the client. Check the client's electrolyte values. Measure the client's weight. Restrict the client's protein intake.

The answer is the second one: Check the client's electrolyte values.

Explanation for each option:

• Administer an analgesic to the client: While the client reports a dull headache, which might suggest the need for pain relief, this is not the most immediate concern given the symptoms and the context of acute kidney injury. The symptoms described (diarrhea, palpitations, muscle tingling, and weakness) suggest potential electrolyte imbalances, which can be life-threatening and should be prioritized.

• Check the client's electrolyte values: This is the correct action to take first. The symptoms the client is experiencing, such as palpitations, muscle tingling, and weakness, are indicative of possible electrolyte imbalances, such as hyperkalemia or hypocalcemia, which are common in acute kidney injury. Checking the electrolyte values will help identify any imbalances that need to be addressed immediately to prevent serious complications.

• Measure the client's weight: While monitoring weight is important in managing fluid balance in patients with kidney injury, it is not the most immediate action needed in response to the symptoms described. Electrolyte imbalances pose a more immediate risk to the client's health.

• Restrict the client's protein intake: Protein restriction can be part of managing kidney injury to reduce the workload on the kidneys, but it is not an immediate action in response to the acute symptoms the client is experiencing. Addressing potential electrolyte imbalances should take precedence.

In summary, the nurse should first check the client's electrolyte values to address the potential life-threatening imbalances suggested by the client's symptoms.