An arterial catheter is inserted in the right radial artery to monitor a patient's blood pressure. Which information obtained by the nurse indicates that a complication of arterial pressure monitoring may be occurring?

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.

In septic shock, one of the key goals of management is to restore and maintain adequate intravascular volume. However, in this case, the patient's urine output is low (30 mL/hr for the past 3 hours), suggesting inadequate renal perfusion and potential fluid overload.
Administering additional normal saline at an increased rate (250 mL/hr) without addressing the low urine output could potentially exacerbate fluid overload and further compromise the patient's condition.
A. Administer hydrocortisone (Solu-Cortef) 100 mg IV in (option A) is incorrect because: Hydrocortisone is commonly used in septic shock to help stabilize blood pressure and modulate the inflammatory response.
B. Giving PRN furosemide (Lasix) 40 mg IV in (option B) is incorrect because Furosemide, a loop diuretic, can be administered as needed to address fluid overload or to increase urine output if there is evidence of volume overload.
D. Titrate norepinephrine (Levophed) to keep systolic BP >90 mm Hg in (option D) is incorrect because: Norepinephrine is a vasopressor commonly used in septic shock to increase systemic vascular resistance and maintain adequate blood pressure.