A patient in septic shock has not responded to fluid resuscitation, as evidenced by a decreasing BP and cardiac output. The nurse anticipates the administration of
nitroglycerine (Tridil).
dobutamine (Dobutrex).
norepinephrine (Levophed).
sodium nitroprusside (Nipride).
The Correct Answer is C
Rationale:
A. Nitroglycerin is a vasodilator used to reduce myocardial oxygen demand in conditions such as angina or heart failure. In septic shock with hypotension, vasodilation is already present; giving nitroglycerin would worsen hypotension.
B. Dobutamine is an inotropic agent that increases cardiac contractility and can improve cardiac output, but it does not reliably increase blood pressure. In septic shock with persistent hypotension despite fluids, the primary need is vasoconstriction to restore perfusion pressure.
C. Norepinephrine (Levophed) is the first-line vasoactive medication for septic shock that is unresponsive to fluids. It is a potent vasoconstrictor that increases systemic vascular resistance, thereby raising mean arterial pressure (MAP) and improving perfusion to vital organs. It also has mild inotropic effects, which can help support cardiac output.
D. Sodium nitroprusside is a potent vasodilator used for hypertensive crises and heart failure with high afterload. It would be dangerous in septic shock with hypotension, as it would further lower blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. Additional skin disruption is incorrect because while avoiding further trauma to burn wounds is important, it is not the primary reason for choosing the intravenous route for narcotics.
B. Burn pain is so severe it requires relief by the fastest route available is partially correct in acknowledging the severity of pain, but the main limitation of other routes is not speed alone—it is absorption.
C. Thrombosis may occur at injection sites is incorrect because thrombosis is not a significant concern with routine pain management in burn patients; it does not dictate the choice of intravenous administration.
D. Tissue edema may interfere with drug absorption via other routes is correct because burn injuries cause massive tissue edema, which can reduce or delay absorption of orally or subcutaneously administered medications. Intravenous administration ensures reliable and rapid delivery of analgesics, providing effective pain control during the critical initial management phase.
Correct Answer is C
Explanation
Rationale:
A. Nitroglycerin is a vasodilator used to reduce myocardial oxygen demand in conditions such as angina or heart failure. In septic shock with hypotension, vasodilation is already present; giving nitroglycerin would worsen hypotension.
B. Dobutamine is an inotropic agent that increases cardiac contractility and can improve cardiac output, but it does not reliably increase blood pressure. In septic shock with persistent hypotension despite fluids, the primary need is vasoconstriction to restore perfusion pressure.
C. Norepinephrine (Levophed) is the first-line vasoactive medication for septic shock that is unresponsive to fluids. It is a potent vasoconstrictor that increases systemic vascular resistance, thereby raising mean arterial pressure (MAP) and improving perfusion to vital organs. It also has mild inotropic effects, which can help support cardiac output.
D. Sodium nitroprusside is a potent vasodilator used for hypertensive crises and heart failure with high afterload. It would be dangerous in septic shock with hypotension, as it would further lower blood pressure.
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