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 C
Explanation
Choice A reason: Asking the parents what caused the bruises is not the best action, as it may not elicit truthful or accurate information. The parents may be the perpetrators of the abuse, or they may be unaware or in denial of the abuse. The nurse should not confront or accuse the parents without sufficient evidence or support.
Choice B reason: Notifying social services is an important action, but not the first one. The nurse should first gather more information and document the findings before making a report. The nurse should also follow the policies and procedures of the health care facility regarding child abuse reporting.
Choice C reason: Asking the toddler what caused the bruises is the best action, as it may provide valuable clues about the source and nature of the injuries. The nurse should use a gentle and nonjudgmental approach, and ask open-ended questions, such as "How did you get these bruises?" or "Who hurt you?" The nurse should also observe the child's behavior and body language, and reassure the child that they are not in trouble.
Choice D reason: Notifying the provider is a necessary action, but not the first one. The nurse should first assess and interview the child, and document the findings. The nurse should also consult with the provider about the appropriate medical care and follow-up for the child. The provider may also assist the nurse in making a report to social services.
Correct Answer is C
Explanation
Choice A reason: Administering alprazolam 0.5 mg PO is not the first action that the nurse should take. Alprazolam is a benzodiazepine that can be used to treat anxiety or insomnia, but it is not a priority intervention for a mother who has experienced a stillbirth. The nurse should assess the mother's emotional and physical needs before giving any medication.
Choice B reason: Contacting the health care facility's clergy is not the first action that the nurse should take. The nurse should respect the mother's spiritual and cultural beliefs and preferences, but not assume that she wants or needs the clergy's presence. The nurse should ask the mother if she would like to have any spiritual support or counseling.
Choice C reason: Offering the mother private time with the newborn is the first action that the nurse should take. This is a sensitive and compassionate way to acknowledge the mother's loss and grief, and to facilitate bonding and closure. The nurse should provide the mother with a quiet and comfortable environment, and allow her to hold, touch, and talk to the newborn as long as she wishes.
Choice D reason: Assisting the client with transferring to the gynecology unit is not the first action that the nurse should take. The nurse should not rush the mother to leave the labor and delivery unit, as this may increase her sense of isolation and abandonment. The nurse should allow the mother to stay in the same room until she is ready to move, and provide her with emotional and physical support during the transition.
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