A nurse is caring for a client in septic shock. The client is still hypotensive and lethargic following a 2,500 mL fluid bolus of lactated Ringer (LR) solution. Which of the following interventions does the nurse anticipate next?
Epinephrine intramuscular (IM) injection
Norepinephrine intravenous (IV) infusion
Dobutamine intravenous (IV) infusion
Dexamethasone intravenous (IV) injection
The Correct Answer is B
A. Epinephrine IM injection is not appropriate in this scenario, as it is typically reserved for treating anaphylactic shock. It is not used for septic shock where hypotension persists after fluid resuscitation.
B. Norepinephrine IV infusion is the correct choice. It is the first-line vasopressor in septic shock management when a fluid bolus does not adequately raise blood pressure. Norepinephrine works by constricting blood vessels, thereby increasing vascular resistance and blood pressure.
C. Dobutamine IV infusion might be considered if there is evidence of myocardial dysfunction or if additional inotropic support is necessary. However, it is not the immediate next step following fluid resuscitation when addressing persistent hypotension in septic shock.
D. Dexamethasone IV injection is not indicated for treating septic shock directly. It may be used in other contexts, such as treating adrenal insufficiency or reducing inflammation, but it does not play a role in immediate blood pressure management in septic shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
D. Weight loss can help improve symptoms of polycystic ovarian syndrome (PCOS) by reducing insulin resistance and androgen levels, which are common issues in PCOS.
A. Thyroid function testing is not specifically related to PCOS management, though thyroid function should be monitored if there are symptoms of thyroid dysfunction.
B. A diet with a low glycemic index is generally recommended for managing PCOS, not a high glycemic index.
C. PCOS is associated with decreased fertility rather than increased fertility. Contraception might be recommended for menstrual regulation, but not necessarily two forms due to increased fertility.
Correct Answer is A
Explanation
A. Petechiae are small, red or purple spots on the skin that indicate bleeding under the skin and are a classic sign of thrombocytopenia, a condition characterized by a low platelet count.
B. A decreased white blood cell count is more indicative of leukopenia, not thrombocytopenia. Thrombocytopenia specifically affects platelet counts.
C. Increased fatigue can be a symptom of many conditions but is not specific to thrombocytopenia. It may occur due to anemia or other side effects of chemotherapy.
D. Unexplained bone pain is not a typical symptom of thrombocytopenia. It might be related to other conditions or side effects but is not specific to low platelet counts.
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