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CCM > Sepsis > Flashcards

Sepsis Flashcards

1
Q

clinical presentation of SIRS

A 
tachycardia
fever
tachypnea
leukocytosis
leukopenia
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2
Q

clinical presentations of severe sepsis

A

sepsis

organ system dysfunction (acidosis, encephalopathy, oliguria, hypoxemia, coagulopathy)

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3
Q

clinical presentation of septic shock

A

hypotension

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4
Q

as sepsis progresses morbidity increases, t or f

A

true

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5
Q

widespread systemic inflammatory response as a result of

A

SIRS

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6
Q

SIRS is most likely triggered by

A

infection - can be a variety of things

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7
Q

SIRS Dx Criteria

A

temp >38 C or 100.4 F
HR >90
RESP >20
WBC >12,000 or

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8
Q

How many dx criteria must be met to suspect SIRS

A

2 or more

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9
Q

what is sepsis

A

infection + SIRS

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10
Q

what is SIRS

A

systemic inflammatory response syndrome

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11
Q

mgmt. of sepsis

A 
baseline lactate levels
blood cultures (before broad spectrum antibiotics)
fluid resuscitation
broad spectrum antibiotics (first)
GOAL *within 3 hours of presentation
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12
Q

dx of sepsis

A

infection is known
temp >38 C or 100.4 F OR 90
RESP >20
WBC >12,000 or

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13
Q

sepsis can develop to severe sepsis quickly, t or f

A

true

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14
Q

what s/s are evident with severe sepsis

A 
Hypotension
Chills
Decreased urine output
Decreased skin perfusion 
Poor capillary refill
Skin mottling 
Decreased platelets 
Petechiae
Hyperglycemia 
Mental status changes
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15
Q

recommended timeframe for sepsis control (from dx to intervention)

A

within 12 hours

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16
Q

1st line vasopressor in sepsis

A

epinephrine

17
Q

when are blood products recommended for sepsis

A

platelet’s less than 10,000-20,000

hemoglobin

18
Q

2 meds used to prevent stress ulcers

A 
proton pump inhibitor (protonix)
H2 blocker (Pepcid)
19
Q

should pt. eat in severe sepsis

A

yes - little amounts

enteral feedings if cant eat

20
Q

surviving sepsis 3 hour window

A

measure lactate level
obtain blood cultures prior to admin of antibiotics
admin broad spectrum antibiotics
admin 30ml/kg crystalloid for hyptotension or lactate

21
Q

what is septic shock

A

sepsis with hypotension despite medical intervention and perfusion abnormalities
lactic acidosis

22
Q

early s/s of septic shock

A 
tachy w/bounding pulse
BP norm/low
widened pulse pressure
warm, flushed skin
irritable, confused
oliguria
hyperthermia
increased CO SvO2
decreased RAP and SVR
23
Q

late s/s of septic shock

A 
tachy w/weak, thready pulse
hypotension
narrow pulse pressure
cool, clammy skin
lethargy/coma
anuric 
hypothermia
decreased CO and SvO2
24
Q

mgmt of septic shock

A 
trt cause (identify within 1 hr)
max. o2 delivery and decrease demand
max cardiac output (keep cvp >8 and HR
25
Q

The nursing caring for a patient admitted with severe sepsis. The practitioner orders include the administration of large volumes of isotonic saline solution as part of early goal directed therapy. Which of the following best represents a therapeutic endpoint for goal- directed fluid therapy?

A

Central venous pressure ≥ 8mm Hg

26
Q

organ damage in MODS is

A

sequential

27
Q

Most common cause of MODS

A

sepsis/septic shock

28
Q

MODS can occur after

A

any severe injury or illness

29
Q

what is MODS

A

dysfunction of 2+ organ systems as a result of uncontrolled inflammatory response to severe illness/injury

30
Q

what events are typically fatal in MODS

A

cardiovascular or CNS

31
Q

which systems are effected in MODS

A 
pulmonary
hematological
renal
hepatic
GI
32
Q

MODS mgmt

A 
support
infection control (antibiotics)
tissue oxygenation (maintain hemoglobin 7-9)
33
Q

manifestations of MODS

A 
tachypnea/hypoxemia
petechiae/bleeding
jaundice
abd. distention
oliguria to anuria
tachy
hypotension
change in LOC

CCM (13 decks)

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