A 58-year-old male patient is being transported by flight after suffering a myocardial infarction. He is currently stabilized but develops sudden oliguria and elevated serum creatinine levels. Which immediate intervention is most appropriate to prevent the progression of acute kidney injury (AKI) in this patient?
Administer diuretics to increase urine output
Monitor urine output and adjust fluid intake accordingly
Initiate fluid resuscitation to maintain adequate perfusion
Wait for further renal function tests before initiating treatment
The appropriate intervention to prevent the progression of AKI is to ensure adequate fluid resuscitation. AKI is often precipitated by hypoperfusion (low blood flow); fluid resuscitation helps in maintaining sufficient blood volume and perfusion pressure to the kidneys. Monitoring for signs of fluid overload is essential, but appropriate fluid balance is typically the immediate concern. Unlike other interventions, such as administering diuretics, ensuring fluid balance directly addresses the hypoperfusion that contributes to AKI. Monitoring urine output and serial lab values are crucial for ongoing assessment but do not directly address the root cause as fluid resuscitation does.
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