Which of the following interventions is considered a priority when treating a patient who presents with septic shock?
obtaining wound and blood
removing or controlling potentially infected sources
initiation of an intravenous line and fluid
drawing blood for hematology and chemistry studies
The Correct Answer is C
Septic shock is a life-threatening condition characterized by severe infection, systemic inflammation, and inadequate tissue perfusion. In this critical situation, one of the initial priorities is to restore intravascular volume and improve tissue perfusion. Initiation of an intravenous line allows for the administration of fluids and other necessary medications to support the patient's hemodynamic stability.
While the other interventions mentioned are also important components of septic shock management, the immediate priority is to address hypotension and tissue hypoperfusion through fluid resuscitation:
A. Obtaining wound and blood cultures in (option A) is incorrect because: Cultures are important to identify the source and causative organisms of the infection. However, fluid resuscitation should take priority over obtaining cultures, as it is necessary to stabilize the patient's hemodynamics.
B. Removing or controlling potentially infected sources in (option B) is incorrect because: Identifying and controlling the source of infection is crucial in septic shock management to prevent further progression. However, initiating fluid resuscitation is more time-sensitive and should be prioritized.
D. Drawing blood for hematology and chemistry studies in (option D) is incorrect because Laboratory studies are important for evaluating organ function and guiding treatment. However, the immediate focus should be on fluid resuscitation to address the underlying hypoperfusion and stabilize the patient's condition.
Therefore, the intervention considered a priority when treating a patient who presents with septic shock is the initiation of an intravenous line and fluid administration to restore intravascular volume and improve tissue perfusion.
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Related Questions
Correct Answer is D
Explanation
Norepinephrine is a vasopressor medication commonly used in the management of septic shock. It acts as a potent vasoconstrictor to increase systemic vascular resistance and improve blood pressure. By constricting blood vessels, norepinephrine helps restore tissue perfusion and improve organ function.
A. Nitroglycerine (Tridil) in (option A) is incorrect because: Nitroglycerine is a vasodilator and would further lower blood pressure. It is not suitable for a patient with septic shock who already has low blood pressure.
B. Atenolol (Tenormin) in (option B) is incorrect because: Atenolol is a beta-blocker and would further decrease heart rate and blood pressure. It is not appropriate for a patient in septic shock who requires intervention to increase blood pressure.
C. Dobutamine (Dobutrex) in (option C) is incorrect because: Dobutamine is an inotropic medication used to increase cardiac output. While it can be helpful in certain types of shock, such as cardiogenic shock, it is not the first-line choice for septic shock when there is inadequate blood pressure response.
Correct Answer is C
Explanation
Septic shock is characterized by inadequate tissue perfusion and hypotension, which can lead to organ dysfunction and failure. The administration of intravenous fluids, such as a normal saline bolus, is the initial priority in the management of septic shock to restore intravascular volume and improve perfusion.
A. Draw an arterial blood gas (ABG) in (option A) is incorrect because: ABG may be ordered to assess the patient's acid-base status and oxygenation, but addressing hypotension and restoring perfusion through fluid administration takes priority.
B. Start insulin drip to maintain blood glucose at 150 mg/dl or lower in (option B) is incorrect because: Hyperglycaemia is commonly observed in critically ill patients, including those with septic shock. While controlling blood glucose is important, it is not the immediate priority compared to addressing hypotension and restoring intravascular volume.
D. Titrate norepinephrine (Levophed) to keep mean arterial pressure (MAP) greater than 65 mm Hg in (option D) is incorrect because: Norepinephrine is a vasopressor medication used to increase blood pressure and perfusion in septic shock. While it may be necessary for the management of septic shock, fluid resuscitation should be initiated first to optimize intravascular volume before starting vasopressors.
Therefore, the first order that the nurse should accomplish in this scenario is to give a normal saline bolus IV of 30 mL/kg to address the hypotension and restore intravascular volume.
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