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30) A patient with septic shock has a urine output of 20 ml/hr for the past 3 hours. Thepulse rate is 120, and the central venous pressure and pulmonary artery wedgepressure are low. Which of these orders by the health care provider will the nursequestion?(a) Give furosemide(b) Increased normal saline infusion(c) Administer hydrocortisone(d) Prepare to give broad spectrum antibiotic

Question

  1. A patient with septic shock has a urine output of 20 ml/hr for the past 3 hours. Thepulse rate is 120, and the central venous pressure and pulmonary artery wedgepressure are low. Which of these orders by the health care provider will the nursequestion?(a) Give furosemide(b) Increased normal saline infusion(c) Administer hydrocortisone(d) Prepare to give broad spectrum antibiotic
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Solution

The nurse should question the order to "Give furosemide" (a). Furosemide is a diuretic, which promotes diuresis (increased production of urine). In a patient with septic shock, the body is already in a state of low fluid volume. The low urine output, increased pulse rate, and low central venous pressure and pulmonary artery wedge pressure are all signs of this. Giving furosemide would further decrease fluid volume, potentially exacerbating the patient's condition.

The other orders are appropriate for a patient with septic shock. Increasing normal saline infusion (b) can help to increase fluid volume and blood pressure. Administering hydrocortisone (c) can help to reduce inflammation in the body. Preparing to give a broad spectrum antibiotic (d) can help to fight the bacterial infection causing the septic shock.

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