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N477 > Infection > Flashcards

Infection Flashcards

1
Q

Sepsis

A

Life threatening organ dysfunction caused by a dysregulated host response to infection which can lead to tissue, organ failure, and death

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2
Q

Septic Shock

A

A subset of sepsis in which circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than sepsis alone

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3
Q

What is phase 1 of septic shock called?

A
  • Early
  • Warm shock
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4
Q

What happens during phase 1 of septic shock?

A
  • Vasodilation
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5
Q

What are the s/s of early septic shock?

A
  • Normal - hypotensive r/t fluid shifts
  • Hyperthermia r/t septicemia
  • Tachycardia
  • Tachypnea
  • Skin warm and flushed
  • Normal urine output
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6
Q

What is phase 2 of septic shock called?

A
  • Late
  • Cold
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7
Q

What happens during phase 2 of septic shock?

A
  • Poor perfusion
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8
Q

What are the s/s of late septic shock?

A
  • Hypotension
  • Normal - hypothermic
  • Tachycardia
  • Dysrhythmias
  • Tachypnea
  • Altered mental status
  • Skin pillow/grayish
  • Mottled skin
  • Edematous
  • Urine output <0.5 ml/kg/hour
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9
Q

Multiple organ dysfunction syndrome (MODS)

A

Failure of 2 or more systems in the body

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10
Q

Disseminated intravascular coagulation (DIC)

A

Clotting cascade activation, causing both clotting and eventually bleeding after platelets and clotting factors are used up by excessive clotting

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11
Q

Hyperglycemia during sepsis

A

Continued stress response of the body trigger ongoing liver release of stored glucose

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12
Q

What are MDROs?

A

Multi-drug resistant organisms

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13
Q

What bacteria causes MRSA?

A

S. aureus

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14
Q

Where is S. aureus normally found on the body?

A
  • Skin
  • Perineum
  • Nose
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15
Q

VRE infections

A

Enterococci bacteria live in intestinal tract normally, but when moved to another area in the body they can cause infection

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16
Q

What antibiotics are used to treat MRSA?

A
  • IV vancomycin
  • IV ceftaroline
  • Oral Linezolid
17
Q

S/S of sepsis

A
  • Confusion/mental status changes
  • Tachypnea
  • Tachycardia
  • Fever/hypothermia
  • Pain/discomfort
  • Clammy/sweaty skin
18
Q

Systemic Inflammatory Response Syndrome (SIRS)

A

Ids people who show signs of infection or inflammation who may be at risk for sepsis

19
Q

SIRS criteria for risk of having sepsis

A
  • Need 2 or more criteria
  • Temp: >38.3 or <36.0
  • Heart rate: >90/min
  • Respiratory rate >20/min
  • WBC: <4,000 or >12,000 or bands >10%
20
Q

Quick Sequential Related Organ Failure Assessment (qSOFA)

A
  • Used outside of ICUs
  • Simple bedside criteria to id patients suspected of having infection and poor outcomes
21
Q

qSOFA scoring

A
  • Hypotension SBP <100 = 1 pt
  • Altered mental status/BCS <15 = 1 pt
  • Tachypnea >22/min = 1 pt
22
Q

Sequential Organ Failure Assessment (SOFA)

A
  • Used in ICUs
  • Predicts sepsis related organ dysfunction, extent/progression. effects of treatment
  • Score of 2 or higher = higher risk of organ dysfunction and poor outcomes
23
Q

MEWS Screening Tool

A
  • IDs patients at risk for clinical deterioration
  • Score of 5 or more = higher risk of death and ICU admission
24
Q

What is lactate/lactic acid

A

Byproduct of cell metabolism that accumulates when cells lack sufficient oxygen

24
Q

Lactic acidosis lactate levels

A

> 4 mol/L

24
Q

Normal lactate levels

A

0.5 - 1 mol/L

24
Q

Concerning lactate levels for sepsis

A

> 2 mol/L

24
Q

What is the first vasopressor preferred in sepsis

A

Norepinephrine (Levophed)

24
Q

What is the second choice of vasopressor for sepsis

A
  • Epinephrine
  • Phenylephrine
  • Vasopressin
24
Q

Glasgow Coma Scale Eye Opening Response Scoring

A
  • Spontaneously = 4
  • To speech = 3
  • To pain = 2
  • No response = 1
24
Q

Vasopressor

A

Medication that increases cardiac output and SVR by increasing heart rate, heart contractility, and induces peripheral vasconsctriction

24
Q

Glasgow Coma Scale Verbal Response Scoring

A
  • Oriented to time, pace, person = 5
  • Confused = 4
  • Inappropriate words =3
  • Incomprehensible sounds = 2
  • No response = 1
24
Q

Glasgow Coma Scale Motor Response Scoring

A
  • Obeys commands = 6
  • Moves to localized pain = 5
  • Flexion withdrawal from pain = 4
  • Abnormal flexion/decorticate = 3
  • Abnormal extension/decerebrate = 2
  • No response = 1

N477 (13 decks)

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