Sepsis Flashcards
describe the basic pathophysiology of sepsis/septic shock
septic shock triggers DIC
DIC causes small thrombi to form throughout the vascular system, which impairs blood flow and causes multiple organ dysfunction syndrome
what kind of shock does sepsis cause?
sepsis is the most common cause of distributive shock
what are common locations for sepsis to occur?
sepsis often originates in the lungs or urinary tract
what is the signature indicator of sepsis?
fever and elevated WBC
risk factors for sepsis
open wounds
invasive devices
age - older adults and babies
immunosuppression - HIV, transplant, chemo
type 2 DM
malnutrition
recent surgery
where are cultures obtained from when testing for sepsis?
blood samples
invasive devices
wounds or abscesses
how is antibiotic therapy initiated?
start after all samples are taken
start with broad spectrum
target after culture results
how is fluid therapy performed?
start with bolus
titrate to maintain MAP and UOP
when are vasoactive medications used?
if fluid therapy does not work
general sepsis symptoms
decreased BP and MAP
tachycardia
cold, clammy, pale skin
increased respiratory rate with decreased SpO2
decreased UOP
what signature symptoms can change in late septic shock?
fever can change to hypothermia
elevated WBC can change to low WBC
preventing sepsis (we all know this)
hand hygiene
gloves always
aseptic technique for insertions and PICC dressing changes
keeping invasive devices clean
remove invasive devices if not needed
when does DIC start during septic shock?
begins in progressive stage of septic shock
lab values of DIC
increased D-Dimer
decreased platelets
prolonged PTT
basically all of the clotting materials have been used up making all of the little clots
how is DIC treated
bolus of NS
packed red blood cells
clotting factors
platelets
