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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is B
Explanation
B. Right-sided heart failure leads to congestion of the systemic venous circulation, resulting in increased central venous pressure (CVP). Elevated CVP is a hallmark sign of right-sided heart failure and is often used clinically to assess right ventricular preload and volume status.
A. BNP is a hormone secreted by the heart in response to increased ventricular stretch and volume overload, and its levels are usually elevated in heart failure, including both left-sided and right-sided heart failure.
C. Specific gravity refers to the concentration of solutes in urine and is often used as a measure of urine concentration.
D. Pulmonary artery wedge pressure (PAWP) is a measure of left atrial pressure and left ventricular end- diastolic pressure. In right-sided heart failure, the primary hemodynamic abnormality is congestion of the systemic venous circulation, rather than elevated left-sided pressures.
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