Question

The physician has decided to use renal replacement therapy to remove large volumes of fluid from a patient who is hemodynamically unstable in the intensive care unit. The nurse should expect which treatment to be used for this patient?

A.Hemodialysis (HD) 3 times per week
B.Automated peritoneal dialysis (APD)
C.Continuous venovenous hemofiltration (CVVH)
D. Continuous ambulatory peritoneal dialysis (CAPD)

Answer 1

Continuous Venovenous Hemofiltration (CVVH) is the expected treatment for the removal of large volumes of fluid in a hemodynamically unstable patient in the ICU, as it allows for continuous and gentle fluid removal.

Step-by-step explanation:

For a patient who is hemodynamically unstable and in the intensive care unit requiring the removal of large volumes of fluid, the nurse should expect Continuous Venovenous Hemofiltration (CVVH) to be used for treatment. CVVH is particularly suited for unstable patients because it allows for continuous removal of fluids and waste products over 24 hours, thus avoiding the rapid fluid shifts associated with hemodialysis (HD). While HD is typically performed three times per week and can remove significant volumes during each session, its intermittent nature may not be well-tolerated by hemodynamically unstable patients. On the other hand, Peritoneal dialysis, both automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD), uses the peritoneum as a filter and is generally less efficient at removing fluids quickly compared to hemofiltration techniques like CVVH.