A patient is admitted with a diagnosis of septic shock. Which collaborative interventions would be anticipated? (Select all that apply.)

Choice A rationale Obtaining blood cultures from all suspected sites is critical to identify the causative pathogen before administering antibiotics. Starting broad-spectrum antibiotics empirically is vital in septic shock, but administering them before cultures can lead to false-negative results, hindering targeted therapy and potentially contributing to antimicrobial resistance. Choice B rationale Temperature dysregulation (hypo- or hyperthermia) in septic shock is related to the systemic inflammatory response and can increase metabolic demand. Controlling temperature using antipyretics for fever or warming blankets for hypothermia aims to decrease oxygen consumption and demand, reducing stress on the already compromised cardiovascular system and supporting cellular function. Choice C rationale A thrombolytic agent, like streptokinase, dissolves existing clots and is typically used for conditions like acute myocardial infarction, pulmonary embolism, or stroke caused by a thrombus. Septic shock involves systemic vasodilation and maldistribution of blood flow, not primarily a large-vessel occlusive thrombosis; thus, thrombolytics are contraindicated and increase the risk of hemorrhage. Choice D rationale Cardiotonic agents (vasopressors/inotropes) like dopamine, dobutamine, or norepinephrine are essential in septic shock to combat refractory hypotension and improve tissue perfusion by increasing mean arterial pressure (MAP) and myocardial contractility. Norepinephrine is often the first-line choice to increase systemic vascular resistance and blood pressure. Choice E rationale Subcutaneous epinephrine (1:00) is primarily used for anaphylaxis or acute allergic reactions due to its potent bronchodilator and vasoconstrictive effects. In septic shock, intravenous vasopressors (like norepinephrine) are required for continuous infusion and immediate systemic effect to manage severe hypotension, making this route and dose inappropriate. Choice F rationale Vigorous intravenous fluid resuscitation with crystalloids (like 0.9.