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IM 7 Test 3 > Sepsis > Flashcards

Sepsis Flashcards

1
Q

normal HCT female

A

36-44

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2
Q

normal HCT male

A

41-50

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3
Q

normal WBC level

A

5-10K

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4
Q

normal plt level

A

150-400K

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5
Q

normal albumin

A

3.4-5.4

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6
Q

normal protein level

A

6-8.3

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7
Q

normal BUN

A

6-20

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8
Q

normal Cr level

A

0.6-1.3

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9
Q

normal Na level

A

135-145

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10
Q

normal K level

A

3.5-5.3

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11
Q

normal bilirubin level

A

0.1-1.2

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12
Q

normal procalcitonin level

A

<0.1

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13
Q

normal lactate level

A

<1

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14
Q

normal PT

A

11-12.5

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15
Q

normal CRP

A

<12

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16
Q

normal CPK female

A

26-192

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17
Q

normal CPK male

A

39-308

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18
Q

what does a Cr above 2 indicate

A

acute/chronic renal failure

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19
Q

normal hgb

A

8-12

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20
Q

normal HCT level

A

35-505

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21
Q

what is SIRS

A

exaggerated defense response

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22
Q

SIRS criteria classes X4

A

2+ of the following:

temp

HR

RR

WBC count

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23
Q

SIRS temp criteria

A

> 100.5 or <96.8

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24
Q

SIRS HR criteria

A

> 90 bpm

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25
Q

SIRS RR criteria

A

> 20 bpm or PaCO2 <32

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26
Q

SIRS WBC count criteria

A

> 12K or <4K or 10% immature bands

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27
Q

Sepsis criteria

A

SIRS + confirmed or suspected infection

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28
Q

Severe sepsis criteria

A

sepsis +

signs of end organ damage +

hypotension +

lactate >4

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29
Q

septic shock criteria

A

severe sepsis with persistent:

signs of end organ damage

hypotesion

lactate >4

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30
Q

3 key responses of body to sepsis

A

activation of inflammation

activation of coagulation

decreased fibrinolysis

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31
Q

sepsis s/s X6

A

2 SIRS

AMS

hyperglycemia

hypoxemia

oliguria

hypotension

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32
Q

normal urine output rate

A

30 mL/hr

0.5 mL/kg/hr

33
Q

1 hour bundle for sepsis

A

measure lactate level

obtain blood cultures BEFORE administering antibiotics

administer broad-spectrum antibiotics

fluid bolus

vasopressors to keep MAP >65

34
Q

how much should be bolused in a septic bundle

A

30 mL/kg

35
Q

when does fluid resuscitation stop in septic bundle

A

CVP is 8-12

36
Q

what is used in a septic bundle fluid resuscitation

A

crystalloid

37
Q

what is CVP

A

central venous pressure monitoring

38
Q

what does CVP measure

A

direct measurement of BP in right atrium and vena cava

39
Q

normal CVP

A

2-6

40
Q

ideal CVP in septic shock

A

8-12

41
Q

what can elevate CVP X5

A

fluid overload

right HF

Pleural effusion

cardiac tamponade

mechanical ventilation

42
Q

what can decrease CVP X3

A

hypovolemia

hypovolemic shock

negative pressure breathing

43
Q

pulmonary MODS s/s X5

A

tachypnea

dyspnea

shallow breathing

hypoxemia

crackles if edema

44
Q

pulmonary MODS labs X2

A

ABG

CVP

45
Q

pulmonary MODS ABG results X3

A

low PaCO2

<80 PaO2

low Pao2/FiO2 ratio

46
Q

pulmonary MODS CVP result

A

> 8

47
Q

CV Dysfunction MODS s/s X4

A

tachycardia

hypotension

decreased capillary refill

skin mottling

48
Q

Renal dysfunction MODS s/s X6

A

elevated Cr

decreased U/O

Electrolyte imbalance (Na)

fluid retention

N/V

Fatigue

49
Q

Hepatic dysfunction MODS s/s X7

A

jaundice

confusion

edema

AST/ALT

low albumin

increased bilirubin

increased CPK

50
Q

Neuro dysfunction MODS s/s X5

A

confusion/delirium

agitation

lethargy

change in LOC

seizures

51
Q

endocrine dysfunction MODS major s/s

A

decreased wound healing

52
Q

hyperglycemic endocrine issues MODS X5

A

polydipsia

polyuria

irritability

stomach pain

dry mouth

53
Q

hypoglycemic endocrine issues MODS X3

A

lethargy

pallor

hunger

54
Q

endocrine dysfunction MODS labs X4

A

glucose/CMP

AST/ALT

albumin

serum amylase and ligase

55
Q

what does amylase and ligase show

A

pancreatitis - blood sugar issues in non DM

56
Q

GI dysfunction MODS s/s X5

A

abd pain

abd distention

hypoactive/absent bowel sounds

tarry stool

bright red stool

57
Q

what does a tarry stool indicate

A

upper GI issue

58
Q

what does a bright red stool indicate

A

lower GI issue

59
Q

anti-inflammatory foods X5

A

Garlic

cinnamon

fish

lean meat

DASH/Mediterranean diet

60
Q

early septic shock findings X4

A

fever

tachycardia

tachypnea

WIDENED pulse pressure

61
Q

progressive shock findings X3

A

decreased LOC

respiratory depression

decreased CVP

62
Q

how is fluid resuscitation evaluated

A

VS

cap refill

skin temp

urine output

CVP

passive leg raises by HCP

63
Q

early sepsis skin temp

A

warm/flushed

64
Q

late sepsis skin temp

A

cool/clammy

65
Q

what do passive leg raises do

A

transfer blood from legs and abdominal compartments to the brain

66
Q

first pressor used

A

levophed

67
Q

what does levophed do

A

cause vasoconstriction

68
Q

what does vasopressin do

A

holds onto water and increases volume

69
Q

what is the second pressor used

A

vasopressin

70
Q

how does dopamine vary by dose

A

constricts in high doses

dilates in low doses

71
Q

when should abx be started in sepsis

A

within first hour

72
Q

initial DIC symptoms x7

A

excessive clotting

thrombosis

gangrene

altered LOC/CVA

SOB/PE

bowel ischemia/infarction

acute renal failure

73
Q

late signs of DIC X6

A

excessive bleeding

petechiae

hematuria

oozing from IV sites

GI bleeding

oozing gums

74
Q

fibrinogen in DIC

A

decreased

75
Q

PT in DIC

A

increases

76
Q

plt count in DIC

A

decreased

77
Q

fibrin products in DIC

A

increased

78
Q

d-dimer in DIC

A

increased

79
Q

normal d-dimer

A

<0.5

IM 7 Test 3 (5 decks)

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