Question

The intensive care nurse is responsible for the care of a patient with shock. What cardiac signs or symptoms would suggest to the nurse that the patient may be experiencing acute organ dysfunction? Select all that apply.

  

Drop in systolic blood pressure of 20 mm Hg from baselines

   

Serum lactate elevated >4 mmol/L

  

Exaggerated response to vasoactive medications

   

Mean arterial pressure (MAP) of ˂60 mm Hg

   

Hypotension that responds to bolus fluid resuscitation

Answer 1

During acute organ failure, systolic blood pressure reduces 20 mm Hg from the base line upto 40 mm Hg. Persistent hypotension is one manifestation for acute organ failure. Others are mean arterial pressure (MAP)less than 65 mm Hg ,serum lactate level elevates more than 2 mmol/L and decreased capillary refill as well. Moreover, hypotension doesn't respond to adequate volume resuscitation only, but with vasopressor to maintain adequate MAP

Management

Large volume of IV fluid infusion

Vasopressor or vasoactive drugs

Intubation

Mechanical ventilation

Answer: all