A nurse in the ICU is caring for a client who is experiencing cardiogenic shock secondary to endocarditis. The provider has just left new orders for the care of this client. Which of the following orders would the nurse most likely see in this client's chart?
a. Titrate O2 to keep saturations between 85 and 90%
b. Ambulate client t.i.d.
c. Administer metoprolol 100 mg po
d. Administer dopamine 10 mcg/kg/min
e. IV to keep systolic BP > 100 mmHg
d. Administer dopamine 10 mcg/kg/min
rationale: "Administer dopamine 10 mcg/kg/min IV to keep systolic BP > 100 mmHg" is correct. Cardiogenic shock is a critical condition in which a client is in a life-threatening situation. The primary care of the nurse is to prevent the condition from occurring and to manage symptoms to prevent it from worsening if it does develop. A client in cardiogenic shock would most likely need medications to maintain an increase in blood pressure to within normal limits and oxygen to keep saturations greater than 95%. Beta blocker medications, such as metoprolol, may actually cause hypotension and can worsen the client's condition.
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