Mr. H. is an 82-year-old man admitted

Mr. H. is an 82-year-old man admitted to the hospital from a nursing home with a diagnosis of urosepsis. Urine cultures revealed gram-negative bacteria and he was started on Bactrim. He continued to be febrile despite antibiotic therapy. After 72 hours, he was transferred to the ICU because of his declining mental status. He was intubated and placed on mechanical ventilation. Despite multiple fluid boluses and a norepinephrine infusion (5mcg/min.), his mean arterial pressure remains lower than 60 mm Hg. This activity contains 5 questions. 1. Identify the functional classification of shock pertinent to Mr. H. 2. Describe the mechanism of impaired oxygenation for this shock state in this patient. 3. Describe the compensatory mechanisms that occurred in response to this shock state. 4. In which stage of compensatory shock is Mr. H.? 5. What are the nursing implications for the patient receiving norepinephrine?

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