The nurse is caring for a client with severe sepsis who is receiving vasopressor therapy. Despite adequate fluid resuscitation, the client's blood pressure remains low. Which intervention should the nurse anticipate as the next step in managing the hypotension?
The nurse is caring for a client with severe sepsis who is receiving vasopressor therapy. Despite adequate fluid resuscitation, the client's blood pressure remains low. Which intervention should the nurse anticipate as the next step in managing the hypotension?
A. Administering a bolus of crystalloid solution
[31%]
B. Initiating continuous renal replacement therapy
[5%]
C. Titrating the vasopressor infusion
[53%]
D. Administering a blood transfusion
[11%]
Statistics
Subject/Lesson
Subject
Critical Care
Lesson
Critical Care Concepts
Client Need
Test Plan
Physiological Adaptation
Related Topic
Hemodynamics
Item Type
Item Type
Application
Explanation
Choice C is correct. If the client's blood pressure remains low despite fluid resuscitation and the initiation of vasopressors, the next step in managing hypotension in sepsis is to titrate the vasopressor up or possibly add a second infusion.
Choice A is incorrect. While fluid resuscitation is essential, this client is not responding adequately to fluids, necessitating the consideration of vasopressors.
Choice B is incorrect. Renal replacement therapy is not the primary intervention for managing refractory hypotension. Vasopressor therapy takes precedence.
Choice D is incorrect. While blood transfusion may be indicated for specific conditions, it is not the primary intervention for managing refractory hypotension in severe sepsis.
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2 Key Topics
Sepsis
23.3 Infection Control & Infectious Diseases
Additional Info
✓ Maintain continuous monitoring of vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation. This allows for prompt identification of any changes in the client's condition.
✓ It may be indicated for the client to get an arterial line. An arterial line provides real-time and continuous blood pressure measurements, offering a more accurate representation of a client's hemodynamic status compared to intermittent measurements with non-invasive cuffs.
✓ Compared to non-invasive blood pressure cuffs, arterial lines pose a lower risk of limb ischemia, making them preferable in situations where maintaining blood flow to extremities is critical.
