Big Bugs
This early clinical finding may be the first sign of declining perfusion in sepsis, even before hypotension occurs.
What is altered mental status or new confusion
This condition occurs when progressive dysfunction of two or more organ systems develops after severe illness or injury.
What is multiple organ dysfunction syndrome?
This hallmark ABG/oxygenation finding in ARDS occurs despite increasing oxygen delivery.
What is refractory hypoxemia?
This hemodynamic value reflects left ventricular preload.
What is PAWP?
This rhythm is treated immediately with defibrillation if the patient is pulseless.
What is ventricular fibrillation or pulseless ventricular tachycardia
A patient with sepsis has a lactate of 4.2 mmol/L, cool mottled skin, and decreasing urine output despite oxygen therapy. This nursing priority comes next.
What is rapid fluid resuscitation and provider/sepsis protocol activation?
A septic patient develops increasing creatinine, worsening oxygenation, altered mentation, and thrombocytopenia. This pattern suggests this complication.
What is MODS?
A patient with pancreatitis develops severe dyspnea, bilateral infiltrates, and SpO₂ 84% on a nonrebreather. This complication is suspected.
What is ARDS?
A low CVP, low PAWP, tachycardia, and hypotension most strongly suggest this shock state.
What is hypovolemic shock?
A patient in atrial fibrillation becomes hypotensive, pale, and confused. This is the priority treatment.
What is synchronized cardioversion?
This finding best indicates that initial sepsis interventions are improving tissue perfusion.
What is decreasing lactate, improving urine output, improved mentation, or stabilizing MAP?
The nurse recognizes renal involvement in MODS when this assessment trend appears.
What is decreasing urine output with rising BUN/creatinine?
This ventilator strategy is used in ARDS to prevent alveolar overdistention and ventilator-induced lung injury.
What is low tidal volume ventilation?
A high PAWP with pulmonary crackles and low cardiac output suggests this problem.
What is cardiogenic shock or left-sided heart failure?
This medication is commonly anticipated for stable narrow-complex SVT after vagal maneuvers fail.
What is adenosine?
A septic patient receives 30 mL/kg crystalloid but remains hypotensive with MAP 58. This treatment should be anticipated next.
What is vasopressor therapy, usually norepinephrine?
In MODS, this nursing action helps detect worsening perfusion before cardiac arrest or profound shock occurs.
What is trending organ-specific markers such as urine output, mentation, lactate, ABGs, platelets, and liver enzymes?
The nurse evaluates that prone positioning is effective when this patient response occurs.
What is improved oxygenation/SpO₂ or improved PaO₂/FiO₂ ratio?
The nurse questions aggressive fluid boluses when the patient has hypotension plus this hemodynamic pattern.
What is elevated PAWP/CVP with signs of fluid overload?
The nurse recognizes torsades de pointes and anticipates this electrolyte-based treatment.
What is magnesium sulfate?
Create a priority nursing plan for a patient with suspected septic shock and worsening perfusion.
What is obtain cultures, administer broad-spectrum antibiotics, give IV fluids, monitor lactate/MAP/urine output, apply oxygen, and prepare vasopressors?
Create a nursing surveillance plan for a patient at high risk for MODS after septic shock.
What is frequent neuro checks, strict I&O, renal/liver labs, coagulation studies, ABGs, oxygenation trends, skin perfusion, lactate, and hemodynamic monitoring?
Create a priority response for an intubated ARDS patient with sudden high-pressure alarm and decreasing SpO₂.
What is assess patient first, check airway/tubing for obstruction or kinks, suction if needed, assess breath sounds, check for pneumothorax, and notify provider/RT?
Create an interpretation of this profile: MAP 54, CVP 2, PAWP 4, SVR high, CO low, cool clammy skin.
What is hypovolemic shock with compensatory vasoconstriction requiring volume resuscitation?
Create a treatment decision: A patient has wide-complex tachycardia at 180, BP 76/40, chest pain, and altered mentation.
What is unstable ventricular tachycardia requiring immediate synchronized cardioversion?