The health care provider orders the following interventions for a ...

[chads108]

The health care provider orders the following interventions for a 67-kg patient who has septic shock with a BP of 70/42 mm Hg and oxygen saturation of 90 on room air. In which order will the nurse implement the actions?
 
  (Put a comma and a space between each answer choice A, B, C, D, E.)
  a. Obtain blood and urine cultures.
  b. Give vancomycin (Vancocin) 1 g IV.
  c. Start norepinephrine (Levophed) 0.5 mcg/min.
  d. Infuse normal saline 2000 mL over 30 minutes.
  e. Titrate oxygen administration to keep O2 saturation >95.

Question 2

To evaluate the effectiveness of ordered interventions for a patient with ventilatory failure, which diagnostic test will be most useful to the nurse?
 
  a. Chest x-ray
  b. Oxygen saturation
  c. Arterial blood gas analysis
  d. Central venous pressure monitoring

[Pamela.irrgang@yahoo.com]

Answer to Question 1

ANS:
E, D, C, A, B
The initial action for this hypotensive and hypoxemic patient should be to improve the oxygen saturation, followed by infusion of IV fluids and vasopressors to improve perfusion. Cultures should be obtained before administration of antibiotics.

Answer to Question 2

ANS: C
Arterial blood gas (ABG) analysis is most useful in this setting because ventilatory failure causes problems with CO2 retention, and ABGs provide information about the PaCO2 and pH. The other tests may also be done to help in assessing oxygenation or determining the cause of the patient's ventilatory failure.

[chads108]

Thanks for the timely response, appreciate it

[tuate]

Excellent