A client with suspected urosepsis has a temperature of 39.1 C, blood pressure 86/48 mm Hg, heart rate 124/min, and lactate 4.2 mmol/L. Blood cultures have been drawn. Which prescribed intervention should the nurse implement next?
1Start broad-spectrum antibiotics and isotonic crystalloid fluids.✓ Correct answer
2Place the client on a cooling blanket and recheck the temperature.
3Delay antibiotics until the urine culture result is available.
4Restrict IV fluids because the heart rate is elevated.
Explanation
Hypotension, tachycardia, fever, and elevated lactate suggest sepsis with poor perfusion. After cultures are obtained, timely broad-spectrum antibiotics and crystalloid fluid resuscitation are priorities. Cooling measures or waiting for final cultures delays treatment, and fluids should not be restricted solely because the heart rate is high.
Clinical Judgment Identify shock physiology and act on time-sensitive sepsis treatment after cultures are obtained.
Memory Tip Sepsis priority: cultures, antibiotics, fluids, reassess perfusion.
KR vs US NCLEX uses lactate and hypotension as cues for urgent sepsis bundle actions.
Clinical Practice GuideCDC sepsis program elements include lactate measurement, blood cultures before antimicrobials, antimicrobial selection, and crystalloid fluid resuscitation for hypotension or elevated lactate.
CautionDo not let fever management distract from shock and perfusion.
Sepsis — Life-threatening organ dysfunction from a dysregulated response to infection, often requiring rapid antibiotics and perfusion support.
Lactate — A marker that can rise with tissue hypoperfusion and is used to risk-stratify suspected sepsis.
Crystalloid — An isotonic IV fluid such as normal saline or lactated Ringer solution used for initial fluid resuscitation.