A nurse is caring for a client in septic shock due to a wound infection. Despite aggressive fluid resuscitation, the client has a blood pressure of 78/50 and a heart rate of 136 beats per minute. The nurse contacts the provider. Which of the following orders does the nurse expect to receive from the provider?

A. Blood pressure 84/50 mm Hg: A blood pressure of 84/50 mm Hg is indicative of hypotension, which may be seen in the progressive or decompensatory stage of shock, not in the compensatory stage, where the body usually maintains blood pressure through compensatory mechanisms.

B. Anuria: Anuria, or the complete absence of urine output, suggests renal failure and is typically seen in the progressive or decompensatory stages of shock when organ perfusion is severely compromised, rather than in the compensatory stage.

C. Petechiae: Petechiae (small, pinpoint hemorrhages) suggest clotting abnormalities or disseminated intravascular coagulation (DIC), which can occur in severe shock but is not typical in the compensatory stage.

D. Confusion: Confusion can occur in the compensatory stage of shock as the body struggles to maintain adequate perfusion to vital organs, particularly the brain. Confusion is often the earliest sign of a decrease in cerebral perfusion and can be expected in this stage of shock.

A. Frequent bowel movements: In peritonitis, the inflammation and infection typically lead to bowel dysfunction, causing a reduction or absence of bowel movements rather than an increase. Therefore, frequent bowel movements would not be expected.

B. Inability to pass stools: Peritonitis often results in bowel paralysis (ileus), preventing the passage of stools. The infection and inflammation in the abdominal cavity interfere with normal gastrointestinal motility, making it difficult or impossible for the patient to pass stools.

C. Hyperactive bowel sounds: In peritonitis, bowel sounds are generally decreased or absent due to the inflammation, which leads to a cessation of normal peristalsis. Hyperactive bowel sounds are more commonly seen in conditions like early bowel obstruction, not in peritonitis.

D. Rigid abdomen: A rigid abdomen, often described as "board-like," is a hallmark sign of peritonitis. This occurs as a result of involuntary muscle guarding in response to the intense pain. It is an emergency finding and indicates a severe, acute condition.

E. Decreased urinary output: Decreased urinary output can occur in peritonitis due to hypovolemia, as the body diverts blood to vital organs, causing reduced renal perfusion. Additionally, systemic inflammation can lead to impaired kidney function, further contributing to oliguria.