A nurse is caring for a client in septic shock. The client is still hypotensive and lethargic following a 2,500 mL fluid bolus of lactated Ringer (LR) solution. Which of the following interventions does the nurse anticipate next?

Epinephrine intramuscular (IM) injection

Norepinephrine intravenous (IV) infusion

Dobutamine intravenous (IV) infusion

Dexamethasone intravenous (IV) injection

Answer and Explanation

The Correct Answer is B

A. Epinephrine IM injection is not appropriate in this scenario, as it is typically reserved for treating anaphylactic shock. It is not used for septic shock where hypotension persists after fluid resuscitation.
B. Norepinephrine IV infusion is the correct choice. It is the first-line vasopressor in septic shock management when a fluid bolus does not adequately raise blood pressure. Norepinephrine works by constricting blood vessels, thereby increasing vascular resistance and blood pressure.
C. Dobutamine IV infusion might be considered if there is evidence of myocardial dysfunction or if additional inotropic support is necessary. However, it is not the immediate next step following fluid resuscitation when addressing persistent hypotension in septic shock.
D. Dexamethasone IV injection is not indicated for treating septic shock directly. It may be used in other contexts, such as treating adrenal insufficiency or reducing inflammation, but it does not play a role in immediate blood pressure management in septic shock.

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Correct Answer is ["33"]

Explanation

To calculate the infusion rate, we'll use the following formula:

Infusion rate (gtt/min) = (Volume to be infused (mL) / Time (min)) ) x Drop factor (gtt/mL)

First, calculate the total volume to be infused:

100 mL / 30 min = 3.33 mL/min

Then, multiply the volume per minute by the drop factor:

3.33 mL/min x 10 gtt/mL = 33.3 gtt/min

Therefore, the nurse should set the manual IV infusion to deliver 33 gtt/min.

A. Bradykinesia, hand tremors, and memory loss B. Ascending paralysis beginning in the lower extremities and dysphagia C. Areas of numbness, weakness in the legs, visual problems D. Choreiform movements and loss of facial expression

Correct Answer is C

Explanation

A. Bradykinesia, hand tremors, and memory loss are more characteristic of Parkinson's disease, not multiple sclerosis.
B. Ascending paralysis beginning in the lower extremities and dysphagia are typical of Guillain-Barré syndrome, not multiple sclerosis. MS does not usually present with paralysis but rather with muscle weakness and sensory disturbances.
C. Early signs of multiple sclerosis often include areas of numbness, weakness in the legs, and visual problems such as optic neuritis. These symptoms result from demyelination and nerve damage in the central nervous system.
D. Choreiform movements and loss of facial expression are associated with Huntington's disease, not multiple sclerosis.

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A nurse is caring for a client in septic shock. The client is still hypotensive and lethargic following a 2,500 mL fluid bolus of lactated Ringer (LR) solution. Which of the following interventions does the nurse anticipate next?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["33"]

Explanation

The nurse is assessing a client with a new diagnosis of multiple sclerosis. Which manifestations would the nurse expect to see that are common early signs of multiple sclerosis?

Correct Answer is C

Explanation

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