Sepsis Flashcards
1
Q
normal HCT female
A
36-44
2
Q
normal HCT male
A
41-50
3
Q
normal WBC level
A
5-10K
4
Q
normal plt level
A
150-400K
5
Q
normal albumin
A
3.4-5.4
6
Q
normal protein level
A
6-8.3
7
Q
normal BUN
A
6-20
8
Q
normal Cr level
A
0.6-1.3
9
Q
normal Na level
A
135-145
10
Q
normal K level
A
3.5-5.3
11
Q
normal bilirubin level
A
0.1-1.2
12
Q
normal procalcitonin level
A
<0.1
13
Q
normal lactate level
A
<1
14
Q
normal PT
A
11-12.5
15
Q
normal CRP
A
<12
16
Q
normal CPK female
A
26-192
17
Q
normal CPK male
A
39-308
18
Q
what does a Cr above 2 indicate
A
acute/chronic renal failure
19
Q
normal hgb
A
8-12
20
Q
normal HCT level
A
35-505
21
Q
what is SIRS
A
exaggerated defense response
22
Q
SIRS criteria classes X4
A
2+ of the following:
temp
HR
RR
WBC count
23
Q
SIRS temp criteria
A
> 100.5 or <96.8
24
Q
SIRS HR criteria
A
> 90 bpm
25
SIRS RR criteria
>20 bpm or PaCO2 <32
26
SIRS WBC count criteria
>12K or <4K or 10% immature bands
27
Sepsis criteria
SIRS + confirmed or suspected infection
28
Severe sepsis criteria
sepsis +
signs of end organ damage +
hypotension +
lactate >4
29
septic shock criteria
severe sepsis with persistent:
signs of end organ damage
hypotesion
lactate >4
30
3 key responses of body to sepsis
activation of inflammation
activation of coagulation
decreased fibrinolysis
31
sepsis s/s X6
2 SIRS
AMS
hyperglycemia
hypoxemia
oliguria
hypotension
32
normal urine output rate
30 mL/hr
0.5 mL/kg/hr
33
1 hour bundle for sepsis
measure lactate level
obtain blood cultures BEFORE administering antibiotics
administer broad-spectrum antibiotics
fluid bolus
vasopressors to keep MAP >65
34
how much should be bolused in a septic bundle
30 mL/kg
35
when does fluid resuscitation stop in septic bundle
CVP is 8-12
36
what is used in a septic bundle fluid resuscitation
crystalloid
37
what is CVP
central venous pressure monitoring
38
what does CVP measure
direct measurement of BP in right atrium and vena cava
39
normal CVP
2-6
40
ideal CVP in septic shock
8-12
41
what can elevate CVP X5
fluid overload
right HF
Pleural effusion
cardiac tamponade
mechanical ventilation
42
what can decrease CVP X3
hypovolemia
hypovolemic shock
negative pressure breathing
43
pulmonary MODS s/s X5
tachypnea
dyspnea
shallow breathing
hypoxemia
crackles if edema
44
pulmonary MODS labs X2
ABG
CVP
45
pulmonary MODS ABG results X3
low PaCO2
<80 PaO2
low Pao2/FiO2 ratio
46
pulmonary MODS CVP result
>8
47
CV Dysfunction MODS s/s X4
tachycardia
hypotension
decreased capillary refill
skin mottling
48
Renal dysfunction MODS s/s X6
elevated Cr
decreased U/O
Electrolyte imbalance (Na)
fluid retention
N/V
Fatigue
49
Hepatic dysfunction MODS s/s X7
jaundice
confusion
edema
AST/ALT
low albumin
increased bilirubin
increased CPK
50
Neuro dysfunction MODS s/s X5
confusion/delirium
agitation
lethargy
change in LOC
seizures
51
endocrine dysfunction MODS major s/s
decreased wound healing
52
hyperglycemic endocrine issues MODS X5
polydipsia
polyuria
irritability
stomach pain
dry mouth
53
hypoglycemic endocrine issues MODS X3
lethargy
pallor
hunger
54
endocrine dysfunction MODS labs X4
glucose/CMP
AST/ALT
albumin
serum amylase and ligase
55
what does amylase and ligase show
pancreatitis - blood sugar issues in non DM
56
GI dysfunction MODS s/s X5
abd pain
abd distention
hypoactive/absent bowel sounds
tarry stool
bright red stool
57
what does a tarry stool indicate
upper GI issue
58
what does a bright red stool indicate
lower GI issue
59
anti-inflammatory foods X5
Garlic
cinnamon
fish
lean meat
DASH/Mediterranean diet
60
early septic shock findings X4
fever
tachycardia
tachypnea
WIDENED pulse pressure
61
progressive shock findings X3
decreased LOC
respiratory depression
decreased CVP
62
how is fluid resuscitation evaluated
VS
cap refill
skin temp
urine output
CVP
passive leg raises by HCP
63
early sepsis skin temp
warm/flushed
64
late sepsis skin temp
cool/clammy
65
what do passive leg raises do
transfer blood from legs and abdominal compartments to the brain
66
first pressor used
levophed
67
what does levophed do
cause vasoconstriction
68
what does vasopressin do
holds onto water and increases volume
69
what is the second pressor used
vasopressin
70
how does dopamine vary by dose
constricts in high doses
dilates in low doses
71
when should abx be started in sepsis
within first hour
72
initial DIC symptoms x7
excessive clotting
thrombosis
gangrene
altered LOC/CVA
SOB/PE
bowel ischemia/infarction
acute renal failure
73
late signs of DIC X6
excessive bleeding
petechiae
hematuria
oozing from IV sites
GI bleeding
oozing gums
74
fibrinogen in DIC
decreased
75
PT in DIC
increases
76
plt count in DIC
decreased
77
fibrin products in DIC
increased
78
d-dimer in DIC
increased
79
normal d-dimer
<0.5
