The nurse is reviewing septic shock with a group of nursing students. It would be correct if the student identifies which causes increased lactate production?
The nurse is reviewing septic shock with a group of nursing students. It would be correct if the student identifies which causes increased lactate production?
A. Decreased anaerobic glycolysis
[19%]
B. Elevated serum bicarbonate levels
[15%]
C. Improved tissue oxygenation
[7%]
D. Inadequate tissue perfusion
[59%]
Statistics
Subject/Lesson
Subject
Critical Care
Lesson
Critical Care Concepts
Client Need
Test Plan
Physiological Adaptation
Related Topic
Alterations in Body Systems
Item Type
Item Type
Knowledge/Comprehension
Explanation
Choice D is correct. In septic shock, elevated lactate production is primarily a consequence of inadequate tissue perfusion. The normal lactic acid level in the blood typically ranges from 0.5 to 2.0 millimoles per liter (mmol/L). Septic shock is characterized by widespread vasodilation and reduced vascular tone, leading to insufficient oxygen delivery to the body's tissues. As a response to this lack of oxygen supply, cells shift their metabolism towards anaerobic glycolysis. This anaerobic metabolism produces lactate as a byproduct, causing serum lactate levels to rise. Therefore, elevated lactate levels in septic shock are a result of inadequate tissue perfusion and subsequent anaerobic metabolism.
Choice A is incorrect. In septic shock, anaerobic glycolysis increases due to inadequate tissue oxygenation, leading to elevated lactate levels.
Choice B is incorrect. Septic shock is often associated with metabolic acidosis, which is characterized by decreased serum bicarbonate levels, not elevated levels.
Choice C is incorrect. Septic shock is characterized by tissue hypoxia and inadequate tissue perfusion, not improved tissue oxygenation. Elevated lactate levels reflect tissue hypoperfusion and anaerobic metabolism.
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2 Key Topics
Shock Overview
27.5 Shock
Additional Info
✓ Elevated lactate levels may indicate the presence of multi-organ dysfunction in septic shock. Nurses should be prepared to assess and manage organ function closely, focusing on early recognition and intervention to prevent further deterioration.
✓ Nurses should communicate timely and relevant information to the healthcare team, facilitating prompt decision-making and interventions based on changes in lactate levels and the client's clinical status.
✓ In cases where fluid resuscitation alone is insufficient to maintain adequate blood pressure and perfusion, vasopressor medications may be necessary. Nurses should administer vasopressors according to the prescribed regimen and monitor their effects closely.
