The nurse is caring for a client who has septic shock and has failed to respond to initial treatment. Which of the following infusions would the nurse anticipate if the client has a mean arterial pressure (MAP) of 54 mmHg?
The nurse is caring for a client who has septic shock and has failed to respond to initial treatment. Which of the following infusions would the nurse anticipate if the client has a mean arterial pressure (MAP) of 54 mmHg?
A. Milrinone
[7%]
B. Amiodarone
[19%]
C. Norepinephrine
[71%]
D. Lidocaine
[4%]
Statistics
Subject/Lesson
Subject
Critical Care
Lesson
Critical Care Concepts
Client Need
Test Plan
Pharmacological and Parenteral Therapies
Related Topic
Expected Actions/Outcomes
Item Type
Item Type
Analysis
Explanation
Choice C is correct. Norepinephrine is a common prescription in treating septic shock. It increases vascular tone and the mean arterial pressure (MAP). One of the critical guidelines in treating sepsis is to maintain a mean arterial pressure ( MAP) of 65 mm Hg or more. Initial steps include isotonic fluid boluses to help increase the MAP. If the client does not respond to the initial fluid bolus, vasopressors such as Norepinephrine are used to achieve and maintain the MAP at the target level.
Choices A, B, and D are incorrect. Milrinone is an afterload-reducing agent effective in the treatment of congestive heart failure. This medication lowers blood pressure and would be detrimental to the management of septic shock. Amiodarone and lidocaine are indicated for ventricular dysrhythmias. These medications are not utilized for septic shock.
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6 Key Topics
Hemodynamics
27.3 Critical Care Cardiovascular System
Cardiac Output
27.3 Critical Care Cardiovascular System
Vasoactive Infusions
27.3 Critical Care Cardiovascular System
Additional Info
Septic shock is a distributive shock caused by the client failing to respond to the initial fluid challenge. The nurse should focus on implementing prompt interventions for sepsis which include:
1. Establishing large-bore IV access
2. Collecting prescribed laboratory work such as CBC, CMP, lactic acid, blood cultures, urine culture (if applicable), and procalcitonin (if applicable)
3. Implementing an isotonic fluid bolus of 30 mL/kg
4. Infusing an empirical antibiotic
