A client in septic shock has received 30 mL/kg of crystalloid fluid resuscitation but remains hypotensive with a MAP of 58 mm Hg. The provider orders norepinephrine (Levophed) infusion to be titrated to maintain MAP 265 mm Hg. Which nursing action is the HIGHEST priority when initiating this medication?

A. Norepinephrine is a potent vasoconstrictor, and if it infiltrates peripheral tissue, it can cause severe tissue necrosis and extravasation injury. Administering it through a central venous catheter is the highest priority safety measure when initiating the infusion to prevent serious complications. B. Continuous cardiac monitoring is important because norepinephrine can cause tachycardia, arrhythmias, and increased myocardial oxygen demand, but the risk of tissue injury from peripheral administration is more immediately critical. C. Assessing baseline blood glucose is not a priority for norepinephrine administration. Blood glucose monitoring may be relevant in critical care, but it does not directly prevent complications from norepinephrine infusion. D. Documenting the client’s level of consciousness is important for ongoing assessment of perfusion and neurological status, but it is not the highest-priority action at the time of initiating a vasopressor infusion.