# Patient requires ______ therapy for refractory septic shock.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168365  
> language: ko  
> subject: Certain infectious and parasitic diseases

## 문제

Patient requires ______ therapy for refractory septic shock.

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## 보기

1. vasopressor **✔ 정답**
2. inotropic
3. antiarrhythmic
4. anticoagulant
5. fibrinolytic

**정답: 1**

## 해설

Vasopressor' support is essential in treating hypotension unresponsive to fluid resuscitation in septic shock.

## 임상 시나리오

Septic Shock Treatment Guidelines:

1. First-line vasopressors:
- Norepinephrine (first choice)
- Epinephrine (alternative)
- Vasopressin (adjunct)

2. Clinical indicators:
- MAP < 65 mmHg
- Serum lactate > 2 mmol/L
- Signs of organ dysfunction

3. Treatment sequence:
- Initial fluid resuscitation
- Vasopressor initiation
- Source control
- Broad-spectrum antibiotics

4. Hemodynamic targets:
- MAP ≥ 65 mmHg
- Urine output > 0.5 mL/kg/hr
- Improved tissue perfusion

5. Monitoring parameters:
- Continuous BP monitoring
- Central venous pressure
- ScvO2
- Lactate clearance

6. Additional interventions:
- Mechanical ventilation if needed
- Glycemic control
- Stress ulcer prophylaxis
- DVT prophylaxis

## 핵심 개념

- **vasopressor** — Medications that cause vasoconstriction, increasing blood pressure by tightening blood vessels
- **inotropic** — Drugs that alter the force of heart muscle contraction, affecting cardiac output
- **antiarrhythmic** — Medications used to treat and prevent irregular heartbeats or cardiac arrhythmias
- **anticoagulant** — Medications that prevent blood clot formation by interfering with the blood coagulation process
- **fibrinolytic** — Drugs that break down blood clots by activating plasminogen to dissolve fibrin

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