A 66-year-old female patient in septic shock has received fluid resuscitation, but their mean arterial pressure (MAP) is 52 mmHg. The nurse anticipates the administration of which one of the following?
Nitroglycerine (Tridil).
Atenolol (Tenormin).
Dobutamine (Dobutrex).
Norepinephrine (Levophed).
The Correct Answer is D
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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
In the early stage of septic shock, the body initiates compensatory mechanisms to combat the infection and restore adequate tissue perfusion. Tachypnoea (rapid breathing) and tachycardia (elevated heart rate) are common early signs of septic shock.
Tachypnoea occurs as a response to increased metabolic demand and to compensate for impaired oxygenation and tissue perfusion. Tachycardia is the body's attempt to maintain cardiac output and compensate for decreased blood pressure.
B. Pallor and cool skin in (option B) is incorrect because Pallor and cool skin can occur in later stages of septic shock when perfusion to the peripheral tissues is compromised. However, they are not specific to the early stage.
C. Blood pressure 84/50 mm Hg in (option C) is incorrect because A blood pressure reading of 84/50 mm Hg indicates hypotension, which is typically seen in later stages of septic shock. In the early stage, blood pressure may still be within normal or slightly decreased range.
D. Respiratory acidosis in (optionD) is incorrect because: Respiratory acidosis refers to an imbalance in acid-base status and is not specific to the early stage of septic shock. Acid-base disturbances may occur at any stage of shock but are not indicative of the early stage.
Correct Answer is C
Explanation
In the initial 24 hours after burn injury, fluid resuscitation is a critical priority in the management of burn patients. Burn injuries can lead to significant fluid loss, both locally at the burn site and systemically due to increased capillary permeability. Fluid resuscitation aims to restore and maintain adequate intravascular volume, ensuring sufficient tissue perfusion and organ function.
The Parkland Formula is commonly used to guide fluid resuscitation in burn patients. It involves calculating the total volume of fluid needed in the first 24 hours, with a portion given in the initial hours after injury and the remainder given over the remaining hours.
A. Sterile dressing changes (option A) are incorrect because they are important in wound care management for burn patients to prevent infection. However, fluid resuscitation takes precedence within the first 24 hours.
B. Emotional support (option B) is incorrect because it is an essential aspect of burn care, as burn injuries can have a significant psychological impact. While emotional support is crucial for the patient's overall well-being, it may not be the highest priority within the first 24 hours compared to addressing the physiological needs of fluid resuscitation.
D. Range-of-motion exercises (option D) are incorrect because they are important for preventing contractures and maintaining joint mobility in burn patients. However, they are typically initiated after the initial fluid resuscitation phase and wound stabilization.
Therefore, the priority the nurse anticipates within the first 24 hours for a 31-year-old male patient with burn injuries is fluid resuscitation.
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