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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 A

Explanation

The patient's vital signs indicate signs of septic shock, including low blood pressure (70/46 mm Hg), tachycardia (136 beats/min), and tachypnea (32 breaths/min). The patient also has a high temperature of 104°F, indicating a fever. These findings suggest a systemic response to an infection that is leading to inadequate tissue perfusion.The initial treatment for septic shock includes fluid resuscitation to improve blood pressure and tissue perfusion. A fluid bolus of 0.9% Sodium Chloride (normal saline) is commonly used to restore intravascular volume in septic shock. It helps to increase blood pressure, improve organ perfusion, and stabilize the patient's condition.

The other interventions, such as administering Pantoprazole (Protonix) for gastrointestinal protection, giving Acetaminophen (Tylenol) for fever control, or administering rapid-acting insulin per sliding scale for hyperglycemia, are important aspects of care but should be implemented after the initial fluid resuscitation. The priority at this moment is to address the patient's hypotension and inadequate tissue perfusion through the administration of fluid bolus.

A. A patient who follows a strict vegetarian diet. B. A patient who is morbidly obese C. A patient who is 6 weeks pregnant. D. A patient who drinks a glass of wine monthly.

Correct Answer is B

Explanation

Excess body weight, particularly in the abdominal area, can increase intra-abdominal pressure and lead to the weakening of the lower esophageal sphincter (LES). The LES is responsible for preventing stomach acid from flowing back into the esophagus. When it becomes weakened, it can contribute to the development of GERD. Other risk factors for GERD include certain dietary choices, such as consuming fatty and spicy foods, smoking, pregnancy, and alcohol consumption.

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

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Correct Answer is A

Explanation

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