Wednesday, 28 October 2020

Q. When assessing a client for early septic shock, the nurse should assess the client for which of the following?

A. Cool, clammy skin.

B. Warm, flushed skin.

C. Increased blood pressure.

D. Hemorrhage.

Correct Answer: B

Reason: Warm, flushed skin from a high cardiac output with vasodilation occurs in warm shock or the hyperdynamic phase (first phase) of septic shock. Other signs and symptoms of early septic shock include fever with restlessness and confusion; normal or decreased blood pressure with tachypnea and tachycardia; increased or normal urine output; and nausea and vomiting or diarrhea. Cool, clammy skin occurs in the hypodynamic or cold phase (later phase). Hemorrhage is not a factor in septic shock.

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