A client was admitted 2 days ago with early stages of septic shock. Today the nurse notes that the client's systolic blood pressure, pulse pressure, and cardiac output are decreasing rapidly. Which intervention does the nurse do first?
a. Insert a Foley catheter to monitor urine output closely.
b. Ask the client's family to come to the hospital because death is near.
c. Initiate the prescribed dobutamine (Dobu-trex) intravenous drip.
d. Obtain blood cultures before administer-ing the next dose of antibiotics.
C
The hypodynamic phase of septic shock is characterized by a rapid decrease in cardiac output, systolic blood pressure, and pulse pressure. The nurse must initiate drug therapy to maintain blood pressure and cardiac output. Accurate urinary output and blood cultures are important to the treatment but are not the priority when a client's pulse pressure is decreasing rapidly. The family should be updated appropriately.
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