Using evidence based practice interventions for a patient with acute kidney injury, the nurse is aware that the best approach for fluid volume excess management is:
1. A sodium-restricted diet
2. Diuretics
3. Fluid restriction
4. Plasmapheresis
3
Rationale 1: A sodium-restricted diet alone is not enough. The typical diet would also include potassium restriction and a protein intake of 40–80 gms/day.
Rationale 2: Diuretics, once a mainstay of treatment, are being reconsidered as therapy because these medications, especially furosemide, are nephrotoxic.
Rationale 3: The most effective interventions for fluid volume excess in the patient with acute kidney injury are fluid restriction and renal replacement therapies.
Rationale 4: Plasmapheresis is a blood-purification procedure used to treat several autoimmune diseases, and is not used for fluid volume excess generated by acute kidney injury.
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