A nurse is caring for an adolescent who has been admitted to the PICU with a diagnosis of septic shock. The nurse notes the following :
When planning care for this client, the nurse should anticipate a provider's prescription for which of the following?
Broad-spectrum antibiotics and fluid boluses
Antipyretics and oxygen therapy
Vasopressors and blood transfusions
Corticosteroids and antihistamines
The Correct Answer is A
Choice A reason: Broad-spectrum antibiotics are indicated for septic shock caused by bacterial infection, as they can target a wide range of pathogens and prevent further sepsis. Fluid boluses are also essential to restore the intravascular volume and improve tissue perfusion and oxygenation.
Choice B reason: Antipyretics and oxygen therapy are not sufficient to treat septic shock, as they do not address the underlying infection or the hypovolemia. Antipyretics may lower the temperature, but they do not eliminate the bacteria. Oxygen therapy may improve the pulse oximeter reading, but it does not correct the hypoperfusion.
Choice C reason: Vasopressors and blood transfusions are not the first-line treatments for septic shock, as they may have adverse effects on the cardiovascular system and the coagulation cascade. Vasopressors may increase the blood pressure, but they may also cause vasoconstriction and reduce the blood flow to vital organs. Blood transfusions may increase the hemoglobin level, but they may also increase the risk of fluid overload, hemolysis, and transfusion reactions.
Choice D reason: Corticosteroids and antihistamines are not indicated for septic shock, as they do not have any proven benefits and may have harmful effects on the immune system and the inflammatory response. Corticosteroids may suppress the adrenal function and increase the risk of infection. Antihistamines may cause sedation and dryness of the mucous membranes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Assess the rest of the child's body for a rash.
The child's red marks across the cheeks are characteristic of fifth disease (also known as erythema infectiosum). Fifth disease is caused by parvovirus B19 and typically presents with a bright red rash on the cheeks, often referred to as "slapped cheek" appearance. The rash may eventually spread to other areas of the body, including the arms, trunk, thighs, and buttocks. It is usually mild and self-limiting.
Choice B reason: This option is not appropriate for a rash caused by fifth disease. There is no indication of child abuse or neglect.
Choice C reason: The rash is due to a viral infection and not related to trauma or injury. Questioning the parents is unnecessary.
Choice D reason: While assessing the child's temperature is important in general nursing care, it is not specifically related to the red marks on the cheeks in this case.
Correct Answer is B
Explanation
Choice A reason: Subcutaneous insulin is not the preferred route for a client with DKA, as it has a slower onset and peak than IV insulin. IV regular insulin is the preferred route, as it provides a rapid and continuous infusion of insulin that can be titrated according to the blood glucose level.
Choice B reason: IV regular insulin is the medication of choice for a client with DKA, as it lowers the blood glucose level and reverses the ketosis and acidosis. IV regular insulin has a rapid onset and peak, and can be adjusted based on the client's response.
Choice C reason: IV potassium chloride is indicated for a client with DKA, as the client is at risk of hypokalemia due to osmotic diuresis, insulin therapy, and metabolic acidosis. IV potassium chloride can prevent or treat hypokalemia and its complications, such as cardiac arrhythmias.
Choice D reason: Oxygen via nasal cannula is not necessary for a client with DKA, unless the client has signs of hypoxia or respiratory distress. The client's deep and rapid respirations are a compensatory mechanism for the metabolic acidosis, and do not indicate a need for oxygen therapy.
Choice E reason: Sodium bicarbonate is not recommended for a client with DKA, as it can cause paradoxical cerebral acidosis, hypokalemia, and impaired oxygen delivery. The client's acidosis can be corrected by IV insulin and fluid therapy, which will restore the normal metabolism of glucose and ketones.
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