A nurse is caring for a client in septic shock due to a wound infection. Despite aggressive fluid resuscitation, the client has a blood pressure of 78/50 and a heart rate of 136 beats per minute. The nurse contacts the provider. Which of the following orders does the nurse expect to receive from the provider?

A. Start infusion of Nitroprusside 100mg/250mL D5W: Nitroprusside is a potent vasodilator used to decrease blood pressure, but in septic shock, the priority is to improve perfusion. Lowering blood pressure further could worsen tissue oxygenation. B. Start infusion of Dobutamine 500mg/250mL D5W: Dobutamine is an inotropic agent that increases heart contractility. While it is useful for cardiogenic shock, septic shock is primarily caused by inadequate vascular tone, not impaired heart function, so dobutamine would not be effective. C. Start infusion of Nitroglycerin 50mg/250mL 0.9%NS: Nitroglycerin is a vasodilator, often used in acute coronary syndrome to reduce preload. In septic shock, it could exacerbate hypotension by lowering systemic vascular resistance, further compromising blood pressure and tissue perfusion. D. Start infusion of Norepinephrine 4mg/250mL DSW: Norepinephrine is a vasopressor that increases systemic vascular resistance by constricting blood vessels, which helps elevate blood pressure. In septic shock, where vasodilation and inadequate perfusion are the main issues, norepinephrine is used to restore blood pressure and improve organ perfusion.