A 78-year-old woman is admitted to the orthopedic unit following surgical repair of a right intertrochanteric hip fracture. On postoperative day 2, the nurse notes that the client's urine output has been 25 mL/hr for the past 3 hours, her blood pressure is 88/54 mmHg, heart rate is 112 bpm, and she reports feeling dizzy when the head of the bed is elevated. Her preoperative serum creatinine was 0.9 mg/dL, and today's result is 2.1 mg/dL. Which assessment finding most strongly supports the conclusion that this client's elevated creatinine is due to acute kidney injury (AKI) rather than chronic kidney disease (CKD)?
- The client's urine output is below 30 mL/hr
- The client is reporting dizziness when sitting up
- The creatinine rose acutely from a previously normal baseline in the setting of hemodynamic instability
- The client is 78 years old and has a history of hypertension