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?

Shock is a state of inadequate tissue perfusion, resulting in compromised oxygen and nutrient delivery to cells and impaired cellular metabolism. Regardless of the specific cause or type of shock (e.g., hypovolemic, cardiogenic, distributive), the underlying problem is the failure to supply sufficient oxygen and nutrients to the body's tissues. This inadequate tissue perfusion can lead to cellular dysfunction, organ failure, and ultimately, life-threatening consequences.
A. Inefficient metabolism resulting from inadequate nutrition in (option A) is incorrect because While inadequate nutrition can contribute to the overall health status and resilience of an individual, it is not the central mechanism underlying all shock states.
C. Vasoconstriction and reflexive vasodilation due to circulating mediators in (option C) is incorrect because Vasoconstriction and vasodilation are physiological responses that can occur in various types of shock, but they are not the fundamental common denominator. Inadequate tissue perfusion remains the core issue.
D. Hypovolemia resulting from blood loss in (option D) is incorrect because Hypovolemia, which refers to decreased blood volume, is one potential cause of shock, specifically hypovolemic shock. However, other types of shock, such as cardiogenic or distributive shock, may not be primarily characterized by hypovolemia.
Therefore, the common denominator of all shock states is inadequate tissue perfusion, resulting in impaired cellular metabolism.

Hypovolemic shock is a life-threatening condition resulting from severe blood or fluid loss. The patient in this scenario exhibits signs of hypovolemic shock, such as low blood pressure, tachycardia, cool and clammy skin, and decreased urine output.
When assessing the prescription options, the nurse should consider the appropriateness of each intervention for hypovolemic shock. Plasmanate is a type of plasma protein fraction that is used for volume expansion in certain situations. However, in hypovolemic shock, the primary intervention is to restore intravascular volume promptly. Plasmanate alone may not be sufficient for rapid-volume resuscitation.
In hypovolemic shock, the initial management typically involves the administration of crystalloid solutions, such as Lactated Ringers or Normal Saline, to restore intravascular volume. Therefore, the prescription of Plasmanate as the primary intervention raises concerns and should be questioned by the nurse.
A. Dopamine (Intropin) 12 mcg/min in (option A) is incorrect because: Dopamine is a vasopressor medication used to increase blood pressure and cardiac output. It is a suitable option for hypovolemic shock to support blood pressure and tissue perfusion.
B. Dobutamine (Dobutrex) 5 mcg/kg/min in (option B) is incorrect because: Dobutamine is an inotropic medication that helps improve cardiac contractility and cardiac output. It can be beneficial in cases of hypovolemic shock with signs of poor cardiac function.
D. Bumetanide (Bumex) 1 mg IV in (option D) is incorrect because: Bumetanide is a loop diuretic used to promote diuresis. However, in the context of hypovolemic shock, diuretics are generally not the first-line treatment as they can further reduce intravascular volume and worsen the patient's condition.
It is essential for the nurse to consult with the healthcare provider regarding the prescription order of Plasmanate and consider alternative interventions for rapid volume resuscitation in hypovolemic shock.