The client diagnosed with septic shock has an elevated temperature, a BP of 110/70, and a high cardiac output with systemic vasodilation. Which phase of septic shock is the client experiencing?

• A. Hypodynamic phase.
• B. Compensatory phase.
• C. Hyperdynamic phase.
• D. Progressive phase.

Answer: (C)

In septic shock, an early vasodilatory response produces a hyperdynamic, or warm, phase. Here the inflammatory mediators cause systemic vasodilation, which lowers afterload, and the heart compensates by increasing output. That combination leads to a high cardiac output with warm, flushed extremities and often a blood pressure that can be normal or only mildly reduced. The fever supports an infectious etiology, and the normal-to-high blood pressure alongside the elevated cardiac output and systemic vasodilation fits this initial hyperdynamic state.

If this process worsens, the patient can progress to the hypodynamic phase, where the heart can fail to maintain adequate output, resulting in low blood pressure, cool extremities, and poor perfusion. A progressive phase follows with worsening organ dysfunction despite resuscitation. But the described pattern—fever with high cardiac output and vasodilation and a BP that is not severely low—best corresponds to the hyperdynamic phase.