# 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?

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> language: en  
> subject: Illness Management  
> category: PA

## Question

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?

## Option

1. Place the client on a cooling blanket and recheck the temperature.
2. Delay antibiotics until the urine culture result is available.
3. Restrict IV fluids because the heart rate is elevated.
4. Start broad-spectrum antibiotics and isotonic crystalloid fluids. **✔ Correct answer**

**Correct answer: 4**

## 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.

## In-depth explanation

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 scenario

Clinical Practice Guide
CDC sepsis program elements include lactate measurement, blood cultures before antimicrobials, antimicrobial selection, and crystalloid fluid resuscitation for hypotension or elevated lactate.

Caution
Do not let fever management distract from shock and perfusion.

## Key concepts

- **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.

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