A patient with septic shock has a BP of 70/46 mm Hg. pulse of 136 beats/min, respirations of 32 breaths/min, temperature of 104" F, and blood glucose of 246 mg/dL. Which intervention ordered by the health care provider should the nurse implement first?

Acetaminophen (Tylenol) 650 mg rectally.

Start insulin drip to maintain blood glucose at 110 to 150 mg/dl.

Administer normal saline IV at 500 mL/hr.

Start norepinephrine to keep blood pressure above 90 mm Hg.

Answer and Explanation

The Correct Answer is C

C. The first intervention should be to administer normal saline IV at 500 mL/hr to address the immediate concern of hypotension and inadequate tissue perfusion.

A. While fever control is important, especially in septic shock, administering acetaminophen should not be the first intervention in a patient with severe hypotension and shock. Addressing the low blood pressure and perfusion is a higher priority.

B. Hyperglycemia is common in critically ill patients, including those with septic shock. However, in this scenario, the patient's severely low blood pressure and signs of shock take precedence over managing hyperglycemia. Insulin therapy can be initiated later once the patient's hemodynamic status is stabilized.

D. Norepinephrine is a vasopressor medication commonly used in septic shock to increase blood pressure and improve perfusion to vital organs. It helps counteract the vasodilation and hypotension characteristic of septic shock.

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Correct Answer is []

Explanation

In respiratory acidosis, there is an accumulation of carbon dioxide (CO2) in the blood due to inadequate ventilation, leading to an increase in the partial pressure of arterial carbon dioxide (PaCO2) and a decrease in pH.

This is often caused by conditions that impair ventilation, such as airway obstruction, respiratory muscle weakness, lung diseases (e.g., chronic obstructive pulmonary disease, pneumonia), or central nervous system depression (e.g., drug overdose, head injury).

Management of respiratory acidosis include bronchodilators, sodium bicarbonate, adequate ventilation, and treatment of underlying causes.

A. Anaphylaxis B. Hypovolemia C. Pulmonary embolism D. Myocardial infarction

Correct Answer is D

Explanation

D. Myocardial infarction (heart attack) is a common cause of cardiogenic shock. In myocardial infarction, part of the heart muscle becomes ischemic or necrotic due to occlusion of a coronary artery. This leads to impaired cardiac function and reduced cardiac output, resulting in cardiogenic shock. Prompt recognition and treatment of myocardial infarction are crucial to prevent or manage cardiogenic shock.
A. Anaphylaxis is a severe allergic reaction that can lead to systemic vasodilation and distributive shock, but it is not a common cause of cardiogenic shock. In anaphylaxis, the primary mechanism of shock is typically related to widespread vasodilation and increased vascular permeability rather than impaired cardiac function.
B. Hypovolemic shock occurs due to a decrease in intravascular volume, leading to inadequate tissue perfusion. It is not a common cause of cardiogenic shock, as the underlying mechanism is different. In hypovolemic shock, the primary issue is the loss of circulating blood volume, whereas cardiogenic shock involves impaired cardiac function.
C. Pulmonary embolism can lead to acute right heart strain or failure, which may result in hemodynamic instability and shock. However, pulmonary embolism typically causes obstructive shock rather than cardiogenic shock. Obstructive shock occurs when blood flow is obstructed, such as by a pulmonary embolism, leading to reduced cardiac output.

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A patient with septic shock has a BP of 70/46 mm Hg. pulse of 136 beats/min, respirations of 32 breaths/min, temperature of 104" F, and blood glucose of 246 mg/dL. Which intervention ordered by the health care provider should the nurse implement first?

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Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

Which of the following is a common cause of cardiogenic shock?

Correct Answer is D

Explanation

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