Pharmacology Psych Meds Patho #2

Question

Which reflects effective treatment of a vasopressor, norepinephrine, in a client with septic shock? Select all that apply.

Answers

  1. Increasing heart rate
    • Rationale:

      This answer is correct because increasing heart rate reflects the vasopressor is increasing vascular tone and perfusion by increasing the heart rate. Another indication of effective treatment is increasing blood pressure. The peripheral area (hands and feet) will become cooler and have mottling as blood is shunted to the central organs (heart, lung, brain).

  2. Decreasing blood pressure
    • Rationale:

      This answer is not correct because increasing (not decreasing) blood pressure reflects the vasopressor is increasing vascular tone and perfusion by increasing the blood pressure. Another indication of effective treatment is increasing heart rate. The peripheral area (hands and feet) will become cooler and have mottling as blood is shunted to the central organs (heart, lung, brain).

  3. Decreasing white blood cell count
    • Rationale:

      This answer is not correct because norepinephrine does not decrease white blood cell counts in a client in septic shock. Its use for that client is to help perfuse the central organs through increasing vascular tone and peripheral vasoconstriction. Antibiotics would be given to help decrease the white blood cell count of a person in septic shock.

  4. Increasing temperature of hands
    • Rationale:

      This answer is not correct because decreased (not increased temperature of the hands and feet) is an expected finding as norepinephrine begins to work effectively. This is because the medication causes peripheral vasoconstriction, which shunts peripheral blood to the central organs (heart, lungs, brain). The hands and feet will not only become cooler but mottling of the legs, arms, feet, and hands will occur with peripheral vasoconstrictive action of norepinephrine.

  5. Increasing vascular tone
    • Rationale:

      This answer is correct because increasing blood pressure reflects the vasopressor is increasing vascular tone and perfusion by increasing the blood pressure. Another indication of effective treatment is increasing heart rate. The peripheral area (hands and feet) will become cooler and have mottling as blood is shunted to the central organs (heart, lung, brain).

Overview

Norepinephrine is a potent alpha-adrenergic agonist. It is a “stress hormone” which stimulates the sympathetic nervous system and causes increased vascular tone, heart rate, and blood pressure.

Explanation

Learning Outcomes

Norepinephrine is a potent alpha-adrenergic agonist. It is a “stress hormone” which stimulates the sympathetic nervous system. This powerful vasopressor medication is used when the body is going through shock, which results in decreased perfusion to the central organs, decreased heart rate and blood pressure. The action of this medication causes increased vascular tone which causes peripheral vascular constriction. This medication is a last resort medication to help keep the central organs (e.g., heart, lungs, brain) perfused and working properly. Effective treatment is reflected by increased heart rate, blood pressure, and increased vascular tone, which reflects increasing perfusion.

Test Taking Tip

When deciding on answers that all “increased” or “decreased”, be sure you stop and remember what the correct answers are and then look back and find the correct response. It is easy to get distracted and pick the incorrect answer. Be very careful when these similar, but very different answers are in the answers.

Video Rationale