A 2-year-old child in septic shock is receiving nitroprusside (Nipride). Which of the following findings indicates the need to increase the nitroprusside dosage?
A.
Systolic BP greater than or equal to 78 mm Hg
B.
Urine output is 7 cc/hr
C.
Systemic vascular resistance is 1820 dynes/sec/cm⁻⁵
Nitroprusside is used invasodilatory shockto reduce afterload andlower systemic vascular resistance (SVR). A persistently elevated SVR (normal: ~800–1200 dynes/sec/cm⁻⁵) indicatesineffective vasodilation, necessitating an increase in dosage to optimize cardiac output.
“SVR is an essential parameter in the management of septic shock. Nitroprusside is titrated to decrease SVR and improve tissue perfusion. A persistently high SVR suggests inadequate response to therapy.”
(Referenced from CCRN Pediatric – Direct Care: Cardiovascular Shock and Hemodynamic Monitoring)
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