How does the emergency department nurse caring for a critically ill with septic shock recognize that severe tissue hypoxia is present?

Partial thromboplastin time 64 seconds

Lactate 9.0 mmol/L

Potassium 2.8 mEq/L (2.8 mmol/L)

PaCO2 58 mm Hg

Answer and Explanation

The Correct Answer is B

Lactate is a by-product of anaerobic metabolism that accumulates when there is insufficient oxygen supply to meet cellular metabolic demands. In the context of severe tissue hypoxia, such as in septic shock, the body may resort to anaerobic metabolism, leading to increased lactate production and elevated lactate levels in the blood.
Elevated lactate levels, typically above 4.0 mmol/L, are indicative of tissue hypoxia and inadequate oxygenation at the cellular level. Higher lactate levels, such as 9.0 mmol/L, suggest more severe tissue hypoxia and increased anaerobic metabolism.
A. Partial thromboplastin time (PTT) 64 seconds in (option A) is incorrect because: PTT is a laboratory test that evaluates the intrinsic pathway of the coagulation cascade. While coagulation abnormalities may occur in septic shock, PTT alone does not specifically indicate severe tissue hypoxia.
C. Potassium 2.8 mEq/L (2.8 mmol/L) (option C) is incorrect because Low potassium levels (hypokalemia) can be a concern in septic shock, but it does not directly indicate severe tissue hypoxia.
D. PaCO2 58 mm Hg in (option D) is incorrect because: PaCO2 refers to the partial pressure of carbon dioxide in arterial blood and is a measure of the respiratory status. While an elevated PaCO2 can be a sign of respiratory acidosis, it is not specific to severe tissue hypoxia.
Therefore, in a critically ill patient with septic shock, an elevated lactate level, such as 9.0 mmol/L, indicates severe tissue hypoxia and inadequate oxygenation at the cellular level

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Correct Answer is C

Explanation

Heart rate: 72 beats per minute Stroke volume: 90 mL/contraction

Cardiac output = Heart rate × Stroke volume

Cardiac output = 72 beats/minute × 90 mL/contraction

To simplify the calculation, you can convert the units:

72 beats/minute × 90 mL/contraction = (72 × 90) beats/minute × mL/contraction

Now, perform the multiplication:

72 × 90 = 6,480

Therefore, the cardiac output is 6,480 mL per minute.

The correct answer is:

C. 6,480 mL

A. Doasive Nitrogen 12m mi B. Dobutamine Doubters) 5 mcg/kg/min C. Plasmanate 1 unit D. Bumetanide (Bumex) 1 mg IV

Correct Answer is C

Explanation

Hypovolemic shock is a life-threatening condition resulting from severe blood or fluid loss. The patient in this scenario exhibits signs of hypovolemic shock, such as low blood pressure, tachycardia, cool and clammy skin, and decreased urine output.
When assessing the prescription options, the nurse should consider the appropriateness of each intervention for hypovolemic shock. Plasmanate is a type of plasma protein fraction that is used for volume expansion in certain situations. However, in hypovolemic shock, the primary intervention is to restore intravascular volume promptly. Plasmanate alone may not be sufficient for rapid-volume resuscitation.
In hypovolemic shock, the initial management typically involves the administration of crystalloid solutions, such as Lactated Ringers or Normal Saline, to restore intravascular volume. Therefore, the prescription of Plasmanate as the primary intervention raises concerns and should be questioned by the nurse.
A. Dopamine (Intropin) 12 mcg/min in (option A) is incorrect because: Dopamine is a vasopressor medication used to increase blood pressure and cardiac output. It is a suitable option for hypovolemic shock to support blood pressure and tissue perfusion.
B. Dobutamine (Dobutrex) 5 mcg/kg/min in (option B) is incorrect because: Dobutamine is an inotropic medication that helps improve cardiac contractility and cardiac output. It can be beneficial in cases of hypovolemic shock with signs of poor cardiac function.
D. Bumetanide (Bumex) 1 mg IV in (option D) is incorrect because: Bumetanide is a loop diuretic used to promote diuresis. However, in the context of hypovolemic shock, diuretics are generally not the first-line treatment as they can further reduce intravascular volume and worsen the patient's condition.
It is essential for the nurse to consult with the healthcare provider regarding the prescription order of Plasmanate and consider alternative interventions for rapid volume resuscitation in hypovolemic shock.

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How does the emergency department nurse caring for a critically ill with septic shock recognize that severe tissue hypoxia is present?

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Naxlex Comprehensive Predictor Exams

What is the cardiac output of a patient whose heart rate is 72 beats per minute with a stroke volume of 90 mL/contraction?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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