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22 Cards in this Set
- Front
- Back
What is the first stage of sepsis?
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SIRS (Systemic Inflammatory Response Syndrome)
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A patient with SIRS will have at least two of these signs:
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Core temp < 96.8 or > 100.4
Heart rate over 90 bpm Respiratory rate greater than 20 WBC count <4000 />12000 cells/mm3 OR > 10% immature neutrophils |
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Define severe sepsis:
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Sepsis + evidence of end-organ dysfunction as a result of hypoperfusion
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What are the signs of organ dysfunction?
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lactic acidosis
oliguria acute change in mental status |
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Define Septic Shock:
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SEVERE SEPSIS + persistent HYPOTENSION despite fluid resuscitation and acute CIRCULATORY FAILURE resulting in tissue hypoperfusion.
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Who is at greater risk of developing sepsis?
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Age > 65 or <1
those with chronic illness those who take immunosuppressant agents, those with infection due to surgery or invasive procedures. |
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List the common complications of septic shock:
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myocardial dysfunction
acute renal failure/chronic renal dysfunction disseminated intravascular coagulation (DIC) liver failure longterm neurological complications d/t tissue hypoperfusion |
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Name two early signs of sepsis
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Tachycardia and narrow pulse pressure
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Why do people over the age of 65 have an increased risk of infection? (6)
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1. impaired immunity
2. decreased mobility 3. skin breakdown 4. dementia 5. decreased gag and cough reflex 6. poor bladder emptying |
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Define sepsis:
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The presence of SIRS accompanying an infection
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Leukocytosis
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WBC count > 12,000 cells/mm3
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Leukopenia
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WBC count < 4,000 cells/mm3
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What two findings are almost universal with patients in sepsis
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Tachycardia and hypotension
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Characteristics of "warm sepsis"
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Pt. has had fluid resuscitation,
Tachycardia and hypotension are results of high CO and low peripheral vascular resistance. |
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Causes of "cold sepsis"
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Pt. hasn't had medical care or hasn't had adequate fluid resuscitation resulting in low CO and high peripheral resistance.
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Assessment findings of cold sepsis:
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Cold extremities, diaphoretic, weak, thready pulses. Will need urgent resuscitation.
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As tissue hypoperfusion increases, what also increases and why?
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Respiratory rate will increase to compensate for metabolic acidosis.
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What are signs of poor tissue perfusion?
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pallor, mottling, delayed capillary bed refill
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Signs of DIC:
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petechiae and purpura
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What is the action of a vasopressor?
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it stimulates contraction of the muscle in the capillary/arterial wall causing a rise in blood pressure.
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What is the ideal time frame for treating sepsis?
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Within one hour of presenting sx
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How can you calculate Mean Arterial Pressure (MAP)
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DP + 1/3PP
DP = Diastolic pressure PP = Pulse pressure |