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%.
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.
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