A 66-year-old female patient in septic shock has received fluid resuscitation, but their mean arterial pressure (MAP) is 52 mmHg. The nurse anticipates the administration of which one of the following?
Nitroglycerine (Tridil).
Atenolol (Tenormin).
Dobutamine (Dobutrex).
Norepinephrine (Levophed).
The Correct Answer is D
Norepinephrine is a vasopressor medication commonly used in the management of septic shock. It acts as a potent vasoconstrictor to increase systemic vascular resistance and improve blood pressure. By constricting blood vessels, norepinephrine helps restore tissue perfusion and improve organ function.
A. Nitroglycerine (Tridil) in (option A) is incorrect because: Nitroglycerine is a vasodilator and would further lower blood pressure. It is not suitable for a patient with septic shock who already has low blood pressure.
B. Atenolol (Tenormin) in (option B) is incorrect because: Atenolol is a beta-blocker and would further decrease heart rate and blood pressure. It is not appropriate for a patient in septic shock who requires intervention to increase blood pressure.
C. Dobutamine (Dobutrex) in (option C) is incorrect because: Dobutamine is an inotropic medication used to increase cardiac output. While it can be helpful in certain types of shock, such as cardiogenic shock, it is not the first-line choice for septic shock when there is inadequate blood pressure response.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
In septic shock, prompt administration of antibiotics is crucial in order to target the underlying infection and prevent further progression of the septic process. Antibiotics help to eradicate the causative organisms and reduce the bacterial load, which can help improve patient outcomes.
While all the options mentioned are important interventions in the management of septic shock, initiating antibiotic therapy is considered a priority in order to address the underlying infection and prevent sepsis-related complications.
A. Giving a 2000 mL normal saline bolus in (option A) is incorrect because: Fluid resuscitation is important in septic shock to restore intravascular volume, but antibiotic therapy takes precedence as it directly targets the underlying infection.
B. Starting an insulin drip to maintain blood glucose at 110 to 150 mg/dL in (option B) is incorrect because Glycemic control is important in septic shock, but it is not the first priority compared to addressing the infection.
C. Giving acetaminophen (Tylenol) 650 mg rectally in (option C) is incorrect because Antipyretic medications can help reduce fever, but they do not address the underlying infection or stabilize the patient's condition.
E. Starting norepinephrine (Levophed) to keep systolic blood pressure >90 mm Hg in (option E) is incorrect because: Vasopressor support may be necessary in septic shock to maintain adequate blood pressure, but initiating antibiotics takes priority in order to address the underlying infection.
Therefore, in a patient with septic shock presenting with the given signs and symptoms, the nurse should first implement the intervention of giving the prescribed antibiotics to target the underlying infection.
Correct Answer is D
Explanation
Septic shock is a life-threatening condition characterized by severe infection, systemic inflammation, and inadequate tissue perfusion. Hypotension, as indicated by a low blood pressure reading, is a significant concern in septic shock. It reflects inadequate perfusion to vital organs and tissues, leading to potential organ dysfunction and damage.
While all the assessment data provided may be important and require attention, the low blood pressure (BP) reading indicates impaired systemic perfusion and can contribute to end-organ damage. The nurse should prioritize interventions aimed at improving perfusion and stabilizing the patient's blood pressure.
A. Arterial oxygen saturation is 90% in (option A) is incorrect because While an arterial oxygen saturation of 90% is below the desired range, it is not as immediately life-threatening as low blood pressure. Oxygen therapy and interventions to improve oxygenation should still be initiated, but addressing hypotension takes priority.
B. Urine output of 15 ml for 2 hours in (option B) is incorrect because Decreased urine output is a concerning sign, as it may indicate impaired renal perfusion. However, the immediate concern in septic shock is addressing the low blood pressure to improve overall perfusion, including renal perfusion.
C. Apical pulse 110 beats/min in (option C) is incorrect because: Tachycardia is a common finding in septic shock and represents the body's compensatory response to maintain cardiac output. While it requires monitoring and consideration, low blood pressure is a more significant concern.
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