An immunocompromised older adult has developed a urinary tract infection, and the healthcare team recognizes the need to prevent an exacerbation of the client's infection that could result in sepsis and septic shock. What action should the nurse perform to reduce the client's risk of septic shock?

Insert a new indwelling urinary catheter

Collect blood cultures

Initiate intravenous (IV) antibiotics

Obtain placement of an intravenous access for fluid administration

Answer and Explanation

The Correct Answer is C

A. Inserting a new indwelling urinary catheter could introduce new pathogens and increase the risk of infection rather than reduce it. Indwelling catheters are a known risk factor for urinary tract infections and should be avoided if possible.
B. Collecting blood cultures is an important diagnostic step, especially if sepsis is suspected. However, this action alone does not directly reduce the risk of septic shock. It is a part of the process but not the most immediate intervention.
C. Initiating intravenous (IV) antibiotics is the most critical intervention to reduce the risk of septic shock. Prompt administration of antibiotics can help control the infection before it progresses to sepsis, making this the priority action.
D. Obtaining placement of an intravenous access for fluid administration is necessary for managing sepsis or septic shock, but the first step should be administering antibiotics to treat the infection causing the sepsis. Fluid administration supports blood pressure and circulation but does not directly address the underlying infection.

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Correct Answer is C

Explanation

A. Desmopressin acetate is used to treat diabetes insipidus, not SIADH. In SIADH, there is excessive antidiuretic hormone causing fluid retention and dilutional hyponatremia, so this medication would not be appropriate.
B. Maintaining an IV infusion of 0.45% sodium chloride is not appropriate for SIADH, as this solution can further dilute sodium levels. Treatment usually involves hypertonic saline or fluid restriction.
C. Restricting fluid intake is a key management strategy for SIADH to address the fluid overload and help correct the low sodium levels. This action directly targets the root cause of the hyponatremia by reducing fluid intake.
D. Providing a diet with 2 g of sodium per day may not be sufficient or appropriate for treating SIADH-related hyponatremia. Fluid restriction is more critical in managing this condition.

A. Signs of sympathetic stimulation B. Hypertension C. Cool, moist skin D. Bradycardia

Correct Answer is D

Explanation

A. Neurogenic shock is characterized by the loss of sympathetic tone, leading to parasympathetic predominance. Therefore, signs of sympathetic stimulation, such as tachycardia or sweating, are not present.
B. Neurogenic shock typically causes hypotension, not hypertension, due to vasodilation and decreased systemic vascular resistance.
C. Cool, moist skin is more commonly seen in hypovolemic or septic shock due to peripheral vasoconstriction. In neurogenic shock, vasodilation leads to warm, dry skin.
D. Bradycardia is a hallmark of neurogenic shock due to unopposed parasympathetic stimulation resulting from the loss of sympathetic nervous system control.

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An immunocompromised older adult has developed a urinary tract infection, and the healthcare team recognizes the need to prevent an exacerbation of the client's infection that could result in sepsis and septic shock. What action should the nurse perform to reduce the client's risk of septic shock?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and a sodium level of 123 mEq/L (nl. 135-145 mEq/L). Which of the following prescriptions should the nurse anticipate?

Correct Answer is C

Explanation

The nurse is caring for a client in neurogenic shock following an overdose of anti-anxiety medication. When assessing this client, the nurse should recognize what characteristic of neurogenic shock?

Correct Answer is D

Explanation

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