After receiving a handoff report from the night shift,the nurse completes the morning assessment of a patient with severe sepsis.Vital signs are: blood pressure 95/60 mm Hg,heart rate 110 beats/min,respirations 32 breaths/min,oxygen saturation ( SpO₂ )96% on 45% oxygen via Venturi mask,temperature 101.5° F,central venous pressure ( CVP/RAP )2 mm Hg,and urine output of 10 mL for the past hour.The nurse initiates which provider prescription first? A) Administer infusion of 500 mL 0.9% normal saline every 4 hours as needed if the CVP is less than 5 mm Hg. B) Increase supplemental oxygen therapy to maintain SpO₂ greater than 94%. C) Administer 40 mg furosemide ( Lasix ) intravenous as needed if the urine output is less than 30 mL/hr. D) Administer acetaminophen ( Tylenol ) 650-mg suppository per rectum as needed to treat temperature greater than 101°F.

Question

Quizplus · Accepted Answer

Fluid volume resuscitation is the priority in patients with severe sepsis to maintain circulating blood volume and end-organ perfusion and oxygenation.A 500-mL IV bolus of 0.9% normal saline is appropriate given the patient's CVP of 2 mm Hg and hourly urine output of 10 mL/hr.There is no evidence to support the need to increase supplemental oxygen.Administration of furosemide ( Lasix )in the presence of a fluid volume deficit is contraindicated.

After Receiving a Handoff Report from the Night Shift,the Nurse