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    Med surg 2 proctored examQuestion 75
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    Med surg 2 proctored exam

    Exhibits In what order will the nurse implement these interventions?

    Explanation & Rationale

    B. Blood cultures x 2, taken 5 minutes apart – First Priority: Blood cultures must be obtained before administering antibiotics to accurately identify the causative organism. In a patient showing signs of sepsis—hypotension, tachycardia, tachypnea, fever, and purulent wound drainage—early culture collection is critical to guide effective therapy. A. Tylenol 650 mg PO prn q6h for a temperature above 101°F – Second: Fever management improves patient comfort and reduces metabolic demand but is not immediately life-saving. It is appropriate to administer after cultures are drawn. D. Vancomycin 750 mg IVPB over 1 hour every 24 hours – Third: Broad-spectrum IV antibiotics should be started immediately after cultures are obtained. Early administration is essential to treat sepsis and prevent progression to septic shock, while still ensuring culture results are accurate. C. C&S of abdominal wound drainage – Fourth: Wound culture helps tailor ongoing antibiotic therapy but is secondary to the urgent need to obtain blood cultures and start empiric antibiotic therapy.

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