The nurse is caring for a patient with acute kidney injury that developed after a severe anaphylactic reaction. What is a primary treatment goal of the initial phase that will help to prevent permanent kidney damage for this patient?

Rationale: A. Maintaining a mean arterial pressure (MAP) of 65 mm Hg is important for ensuring adequate renal perfusion in general, but in the initial phase of acute kidney injury (AKI) following an anaphylactic reaction, the immediate priority is to restore intravascular volume. Hypotension from anaphylaxis causes decreased renal perfusion, which must be corrected first to prevent ischemic injury. B. Antibiotics are not indicated unless there is a documented or suspected infection. In this scenario, the AKI is due to hemodynamic instability, not infection. C. Antihistamines help manage the allergic response during the acute phase of anaphylaxis but do not directly prevent kidney damage once perfusion has already decreased. D. The primary treatment goal during the initial phase of AKI secondary to anaphylaxis is to restore circulating blood volume and renal perfusion by administering IV isotonic fluids (normal saline). This helps maintain glomerular filtration rate (GFR), prevents tubular ischemia, and reduces the risk of permanent kidney damage. Fluid resuscitation is critical before considering vasopressors or other supportive measures.