Infection

Question 1

what are 5 populations that are at increased risk for sepsis

Answer 1

older adults, immunosuppression, chronic illness, undergoing surgery, malnutritin

Question 2

explain the pathophysiology of sepsis

Answer 2

microorganism invade the body tissues which causes an immune response. this leads to capillary instability and vasodilation. this leads to a widespread inflammatory response called systemic inflammatory response syndrome. cytokines will also activate the coagulation system leading to blood clots. this can occlusions of blood vessels

Question 3

what criteria defines SIRS (temp, wbc count, heart, breathing)

Answer 3

temp: above 38.3 or below 36
wbc: greater than 12000 cells/mm3, less than 4000 cells/mm3, or greater than 10% immature wbc (bands)
tachycardia
tachypnea

Question 4

explain the evolution of symptoms in the case of septic shock (bp, heart rate, body temp, respiratory rate, urine output)

Answer 4

• bp is normal or hypotensive with response to fluids. bp later does not respond to fluids
• heart rate increases
• hyperthermia, fever, and bounding pulses. later body temp drops and skin becomes cool
• respiratory rate is elevated
• urine output may be normal. later urine output decreases

Question 5

how is sepsis corrected/what measures can be taken to reduce the chances of mortality

Answer 5

rapidly identify the source of infection, reestablish tissue perfusion through use of fluids, broad spectrum antibiotics until a culture is received, sedation, enteral or parenteral feedings

Question 6

what is neurogenic shock

Answer 6

vasodilation occurs due to an imbalance between parasympathetic and sympathetic stimulation

Question 7

what does neurogenic shock do to an individuals in terms of bp, hr, and skin appearance

Answer 7

bp: hypotension
hr: bradycardia
skin: dry and warm

Question 8

what are 4 causes of neurogenic shock

Answer 8

spinal cord injury, spinal anesthesia, nervous system damage, depressant action of medications

Question 9

what is important for the nurse to do in terms of bed positioning when the patient is receiving spinal or epidural anesthesia

Answer 9

maintain the head of the bed at at least 30 degrees

Question 10

what must the nurse continually assess for in the case of neurogenic shock in terms of the peripheral vascular system

Answer 10

VTE. signs to watch for includes pain, redness, tenderness, and warmth

Question 11

what are the 3 defining characteristics of anaphylaxis

Answer 11

• acute onset
• the presence of two or more symptoms: respiratory compromise, hypotension, gi distress, skin or mucosal irritation
• cardiovascular compromise

Question 12

what are 6 symptoms of anaphylaxis

Answer 12

headache, lightheadedness, nausea, vomiting, abdominal pain, pruritus

Question 13

what are 5 manifestations of severe c. diff

Answer 13

watery diarrhea 10-15 times a day, severe abdominal pain, tachycardia, fever, increased white blood cell count

Question 14

when do signs and symptoms of c. diff commonly occur

Answer 14

5-10 days after starting antibiotics

Question 15

what is first line treatment for mods (multi organ dysfunction syndrome)

Answer 15

oxygen, fluids, vasopressors, anitbiotics

Question 16

what is second line therapy for mods

Answer 16

corticosteroids, insulin, dialysis, mechanical ventilation, blood transfusions