A 71-year-old woman has fever, confusion, dysuria, blood pressure 82/48 mm Hg, heart rate 122/min, and lactate 4.1 mmol/L. Urinalysis shows pyuria

Question

A 71-year-old woman has fever, confusion, dysuria, blood pressure 82/48 mm Hg, heart rate 122/min, and lactate 4.1 mmol/L. Urinalysis shows pyuria and bacteria. She has no pulmonary edema. Which of the following is the most appropriate next step in management?

Accepted Answer

Give crystalloid fluids and broad-spectrum antibiotics promptly

Answer

Restrict fluids because lactate is elevated

Answer

Wait for urine culture before antibiotics

Answer

Start beta blocker for tachycardia

Answer

Treat with oral nitrofurantoin and discharge

Sepsis — USMLE Step 3 MCQ

A 71-year-old woman has fever, confusion, dysuria, blood pressure 82/48 mm Hg, heart rate 122/min, and lactate 4.1 mmol/L. Urinalysis shows pyuria and bacteria. She has no pulmonary edema. Which of the following is the most appropriate next step in management?