Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Foundations II Exam 6 (Jess) > Sepsis > Flashcards

Sepsis Flashcards

1
Q

What is systemic inflammatory response syndrome?

A

Uncoordinated and exaggerated responses of the body to inflammation caused by noninfectious cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Sepsis?

A

SIRS + infection = SEPSIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Severe Sepsis?

A

Acute organ dysfunction secondary to documented suspected infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Septic Shock?

A

Severe sepsis with hypotension or hypoperfusion that is not corrected with fluid resuscitation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do you need to meet SIRS Criteria? (what 4 variables)

A

2 or more if the following:

  • Temp > 38.0 C
  • HR > 90 bpm
  • RR > 20 breaths/min or PaCO2 < 32 mmHg
  • WBCs > 12,000 or < 4,000
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can cause SIRS?

A

pancreatitis
burns
trauma
ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnostic criteria for sepsis?

A

Same as SIRS
+
identified/suspected Infection
(PNA, UTI/pyelonephritis, cellulitis, meningitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some indicators of tissue hypo perfusion or organ dysfunction with sepsis?

A 
elevated lactate
AKI (decreased UOP, creatinine increase)
acute lung injury
bilirubin >2
Plts <100K
INR >1.5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is septic shock? what is the initial volume resuscitation given?

A

severe sepsis w/ hypotension or hypo perfusion that is not corrected w/ fluid resuscitation

inadequate blood/oxygen supply to meet tissue demand

(30 ml/kg crystalloids is considered adequate volume)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is multiple organ dysfunction syndrome?

Examples?

A

Progressive organ dysfunction/failure where homeostasis cannot be maintained without intervention.

Examples:
ARDS
Liver Failure
Renal Failure
Encephalopathy/Coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the issue seen in sepsis?

A

Tissues have higher demand for oxygen and just not able to supply them w/ enough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What occurs when the pro-inflammatory cells outnumber the anti-inflammatory cells?

A

vasodilation

results in decreased BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 3 phases of SIRS/Sepsis?

A

Phase 1: Typical insult -> Balanced response of pro-inflammatory and anti-inflammatory responses
-Vasodilatation
-Leukocyte accumulation
Increased microvascular permeability

Phase 2: Size and/or number of insults increases ->imbalanced response

Phase 3: Multi-organ dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Who is at risk of sepsis?

A 
Elderly 
Immunocompromised
Chronic illness
Malignancy
Genetic factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the cardiac effects of sepsis?

A

decreased L ventricular performance

reduced blood flow to organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the vascular effects of sepsis?

A
  • decrease in capillary fxn
  • venous dilation
  • endothelial permeability
17
Q

What are the lung effects of sepsis?

A

ARDS

18
Q

Neuro effects of sepsis?

A

parasympathetic dysfunction

sx:
confusion, agitation

19
Q

What do you need to do within the first 3 hours of sepsis?

A

1) lactate
2) obtain blood cultures
3) give broad spectrum abx
4) 30 mL/kg crystalloid for htn

20
Q

What needs to be done w/in 6 hrs of sepsis?

A
  • vasopressors
  • volume resuscitation
  • remeasure lactate
21
Q

What is the primary workup in sepsis and when does it need to be completed by?

A

Within 3 hours of presentation:

  • cbc
  • electrolytes w/ BUN/creatinine
  • lactate
  • PT/INR
  • LFTs
22
Q

What does the secondary workup include?

A
  • UA
  • blood cultures (at least 2 different site)
  • CXR
  • rapid infusion antigen (viral/bacterial pathogen panel)
23
Q

Where is the highest level of production of lactate found?

Under normal conditions what is it cleared by?

A

muscle

the liver

24
Q

What does an elevated lactate indicate in general?

A

that we are moving away from aerobic to anaerobic, so not providing enough oxygen to the body

25
Q

What is severe sepsis and how do you figure that out?

A

Sepsis + organ dysfunction = Severe Sepsis

  • Creatinine >
  • Abnormal LFTs
  • Lactate >2
26
Q 
What are the goals of initial resuscitation:
CVP 
MAP
UOP
SVO2
A

CVP 8-12
MAP > 65 mmHg
UOP > 0.5 ml/kg/hr
SVO2 > 70%

27
Q

How many liters of IV fluids are required to adequately perform fluid resuscitation?

A

2-3

NS 30ml/kg SCC guideline

28
Q

what procedures do you do in a pt w/ sepsis to monitor hemodynamics? what do they measure?

A

arterial line- continuous BP monitoring and ABGs

central line- Draw blood, administer meds, monitor CVP (ex= PICC line, subclavian Cath, IJ Cath)

29
Q

When do abx for sepsis need to be given?

A

within the first hour of recognition!!
(broad spectrum)

(or you’re fired)

30
Q

Other than giving abx, what else do you do to treat sepsis?

A
  • source control asap (whatever is causing the sepsis)
  • fluid resuscitation (crystalloids preferred over colloids)
  • vasopressors (norepinephrine= first line)
31
Q

When are steroids indicated in sepsis?

A

IV hydrocortisone is recommended if initial resuscitation efforts have failed (for htn)

Patients on chronic steroids will need stress-dose steroids

32
Q

What does blood glucose need to be under w/ sepsis?

A

< 180

33
Q

How often do you check the blood sugar in a pt w/ sepsis and how do you treat them if they are hyperglycemic?

A

every 1-2 hrs

tx w/ sliding scale insulin regimen

34
Q

What do you give to high risk pts to prevent stress ulcers in the ICU??

A

PPI or H2 blocker

35
Q

What do you give for DVT prophylaxis?

A

low molecular weight heparin (Lovenox) daily

or SubQ heparin if creatinine clearance <30ml/min

36
Q

What is the benefit of using the SOFA score over SIRS or qSOFA?

A

it has been found to be a better predictor of in-hospital mortality

Foundations II Exam 6 (Jess) (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions