Exam 12: Shock,Sepsis,and Multiple Organ Dysfunction Syndrome

The nurse is caring for a patient in cardiogenic shock who is being treated with an infusion of dobutamine.The physician's order calls for the nurse to titrate the infusion to achieve a cardiac index of greater than or equal to 2.5 L/min/m².The nurse measures a cardiac output,and the calculated cardiac index for the patient is 4.6 L/min/m².What is the best action by the nurse?

The nurse is caring for a patient admitted with shock.The nurse understands which assessment findings best assess tissue perfusion in a patient in shock? (Select all that apply.)

The nurse is starting to administer a unit of packed red blood cells (PRBCs)to a patient admitted in hypovolemic shock secondary to hemorrhage.Vital signs include blood pressure 60/40 mm Hg,heart rate 150 beats/min,respirations 42 breaths/min,and temperature 100.6° F.What is the best action by the nurse?

The nurse is caring for a 70-kg patient in hypovolemic shock.Upon initial assessment,the nurse notes a blood pressure of 90/50 mm Hg,heart rate 125 beats/min,respirations 32 breaths/min,central venous pressure (CVP/RAP)of 3 mm Hg,and urine output of 5 mL during the past hour.Following physician rounds,the nurse reviews the orders and questions which order?

Which patient being cared for in the emergency department is most at risk for developing hypovolemic shock?

The nurse is caring for a patient in the early stages of septic shock.The patient is slightly confused and flushed,with bounding peripheral pulses.Which hemodynamic values is the nurse most likely to assess?

The nurse is caring for a mechanically ventilated patient following insertion of a left subclavian central venous catheter ( CVC ).Which action by the nurse best protects against the development of a central line-associated bloodstream infection ( CLABSI )?

The nurse is caring for a patient admitted following a motor vehicle crash.Over the past 2 hours,the patient has received 6 units of packed red blood cells and 4 units of fresh frozen plasma by rapid infusion.To prevent complications,what is the priority nursing intervention?

The nurse has just completed administration of a 500 mL bolus of 0.9% normal saline in a patient with hypovolemic shock.The nurse assesses the patient to be slightly confused,with a mean arterial blood pressure (MAP)of 50 mm Hg,a heart rate of 110 beats/min,urine output of 10 mL for the past hour,and a central venous pressure (CVP/RAP)of 3 mm Hg.What is the best interpretation of these results by the nurse?

A patient is admitted after collapsing at the end of a summer marathon.The patient is lethargic,with a heart rate of 110 beats/min,respiratory rate of 30 breaths/min,and a blood pressure of 78/46 mm Hg.The nurse anticipates administering which therapeutic intervention?

The nurse is caring for a patient in cardiogenic shock experiencing chest pain.Hemodynamic values assessed by the nurse include a cardiac index (CI)of 2.5 L/min/m²,heart rate of 70 beats/min,and a systemic vascular resistance (SVR)of 2200 dynes/sec/cm^-5.Upon review of physician orders,which order is most appropriate for the nurse to initiate?

While monitoring a patient for signs of shock,the nurse understands which system assessment to be of priority?

Ten minutes following administration of an antibiotic,the nurse assesses a patient to have edematous lips,hoarseness,and expiratory stridor.Vital signs assessed by the nurse include blood pressure 70/40 mm Hg,heart rate 130 beats/min,and respirations 36 breaths/min.What is the priority intervention?

The nurse has just completed an infusion of a 1000 mL bolus of 0.9% normal saline in a patient with severe sepsis.One hour later,which laboratory result requires immediate nursing action?