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The initial bundle of care in sepsis includes which of the following? (Select all that apply.)

Administer anti-hypertensives

Obtain blood cultures

Administer broad spectrum antibiotics

Obtain lactate levels

Administer IV fluid bolus

Answer and Explanation

Correct Answer : B,C,D,E

The initial bundle of care in sepsis includes the following:

Obtain blood cultures: Blood cultures help identify the specific microorganism causing the infection, which is important for guiding appropriate antibiotic therapy.
Administer broad-spectrum antibiotics: Early administration of antibiotics is crucial in sepsis to target the suspected or likely infectious organisms. Broad-spectrum antibiotics cover a wide range of potential pathogens until more specific information from culture results is available.
Obtain lactate levels: Measuring lactate levels helps assess tissue perfusion and can be used as an indicator of the severity of sepsis. Elevated lactate levels are associated with tissue hypoperfusion and increased mortality.
Administer IV fluid bolus: Early aggressive fluid resuscitation is an essential component of sepsis management. Administering intravenous fluids helps restore intravascular volume and improve tissue perfusion.
Administration of vasopressors: Especially in the setting of hypotension and to maintain MAP above 65mmHg.

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Correct Answer is ["250"]

Explanation

To calculate the rate at which the nurse should set the IV pump in mL/hr, we need to determine the infusion rate.

The client is receiving 1 gram of antibiotic in 500 ml of fluid over 2 hours. To find the rate in mL/hr, we divide the total volume (500 ml) by the total time (2 hours):

Rate = Volume / Time Rate = 500 ml / 2 hours Rate = 250 ml/hr

Therefore, the nurse should set the IV pump at a rate of 250 mL/hr.

A. Urine output and electrolyte levels. B. Understanding of how to prevent falls. C. Peripheral vascular perfusion and pain. D. Risk for bleeding and white blood cell count (WBC)

Correct Answer is A

Explanation

Acute renal failure is characterized by a sudden decline in kidney function, resulting in the inability of the kidneys to adequately filter waste products and maintain fluid and electrolyte balance. Monitoring urine output is essential in assessing kidney function and determining the severity of renal failure. A decrease in urine output or anuria may indicate worsening renal function and the need for immediate interventions.

Assessing electrolyte levels, such as sodium, potassium, calcium, and phosphorus, is crucial because renal failure can disrupt the balance of these electrolytes in the body. Imbalances can lead to complications such as electrolyte abnormalities, cardiac dysrhythmias, and neuromuscular disturbances. Prompt identification and management of electrolyte imbalances are essential in preventing further complications and supporting optimal patient outcomes.

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The initial bundle of care in sepsis includes which of the following? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

The client is to receive an antibiotic 1 gram in 500 ml of fluid intravenously over 2 hours. At what rate will the nurse set the IV pump in mL/hr.? (Answer as whole number)

Correct Answer is ["250"]

Explanation

The nurse is admitting a client diagnosed with acute renal failure (ARF). The nursing assessment will prioritize ...

Correct Answer is A

Explanation

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