The critical care nurse is delivering a peer lecture on guidelines for the management of SIRS and severe sepsis. Which intervention would the nurse describe as improving outcomes in septic shock?
1. Use bicarbonate for pH of 7.30.
2. Keep mechanically ventilated patients flat in bed.
3. Maintain blood glucose lower than 150 mg/dL.
4. Initiate antibiotic therapy within 4 hours of diagnosis.
3
Rationale 1: Bicarbonate therapy is not recommended for treatment of hypoperfusion-induced lactic acidemia with a pH greater than 7.15.
Rationale 2: Mechanically ventilated patients should be maintained in a semirecumbent position.
Rationale 3: Current evidence indicates that maintaining blood glucose <150 mg/dL improves lipid levels and has anti-inflammatory and anticoagulant effects, improving the chances of survival.
Rationale 4: Antibiotic therapy should be initiated within the first hour of identifying sepsis.
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Which is the best goal when planning nursing care for an older patient with diabetes mel-litus?
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Which client goal, established by the nurse, is most important as the nurse plans care for a seizure client in the home setting?
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