The nurse is caring for a patient who has septic shock. Which ...

[Metfan725]

The nurse is caring for a patient who has septic shock. Which assessment finding is most important for the nurse to report to the health care provider?
 
  a. Blood pressure (BP) 92/56 mm Hg
  b. Skin cool and clammy
  c. Oxygen saturation 92
  d. Heart rate 118 beats/minute

Question 2

When the nurse educator is evaluating the skills of a new registered nurse (RN) caring for patients experiencing shock, which action by the new RN indicates a need for more education?
 
  a. Placing the pulse oximeter on the ear for a patient with septic shock
  b. Keeping the head of the bed flat for a patient with hypovolemic shock
  c. Increasing the nitroprusside (Nipride) infusion rate for a patient with a high SVR
  d. Maintaining the room temperature at 66 to 68 F for a patient with neurogenic shock

[rachel]

Answer to Question 1

ANS: B
Because patients in the early stage of septic shock have warm and dry skin, the patient's cool and clammy skin indicates that shock is progressing. The other information will also be reported, but does not indicate deterioration of the patient's status.

Answer to Question 2

ANS: D
Patients with neurogenic shock may have poikilothermia. The room temperature should be kept warm to avoid hypothermia. The other actions by the new RN are appropriate.

[Metfan725]

Thank you

[rachel]

Happy to help you