Sepsis Pathophysiology
The syndrome characterized by two or more of the following: fever, tachycardia, tachypnea, elevated WBC or neutropenia, hyperglycemia (in the absence of diabetes), and altered mental status.
What is Systemic Inflammatory Response Syndrome?
The timeframe in which broad spectrum antibiotics should be administered.
What is 1 hour?
After positive suicide screen, this is the frequency that the Columbia Suicide Severity Risk Scale should be performed.
What is daily (and PRN with changes)?
Decreased tissue perfusion related to volume depletion with treatment focusing on fluid resuscitation.
What is hypovolemic shock?
Orders for a urine culture on a patient who's Foley that has been in for a week requires this.
What is placing a new Foley catheter?
Decreased tissue oxygenation caused by something rotten (infection).
What is septic shock?
What is "adequate fluid resuscitation" for an initial fluid bolus when the patient qualifies for severe sepsis?
What is 30 mLs/kg?
The scale used to assess for withdrawal in patients who abuse alcohol.
What is CIWA?
The most exciting 3 hours you get to spend each month with your CRNs and friends from other units.
What is critical care nurse residency?
A common antibiotic that IS NOT broad spectrum.
What is vancomycin?
The cause of hypotension in septic shock
What is increased blood vessel diameter and increased permeability caused by the inflammatory response?
Laboratory test that should be drawn within one hour of severe sepsis recognition.
What are blood cultures?
The product of muscle degeneration releases this into the blood stream in rhabdomyolysis.
What is myoglobin?
Flushed skin, difficulty swallowing, weak and rapid pulse, and difficulty breathing may indicate this.
What is anaphylactic shock?
Major symptom of early septic shock
What is warm skin?
When a patient can no longer pull the oxygen from the environment into their bloodstream
What is ARDS (acute respiratory distress syndrome)?
Laboratory test that RRT/RN/Provider draws to identify severe sepsis.
What is lactic acid?
A syndrome with altered organ function that may require multiple medical treatments, such as: fluid administration, vasopressors, mechanical ventilation, and renal replacement therapy.
What is MODS (Multiple Organ Dysfunction Syndrome)?
Hypotension, tachycardia, decreased cardiac output, pale, cool extremities, low urine output, and weak pulses could indicate this.
What is cardiogenic shock?
Increases sepsis bundle compliance by 30-40%.
What is calling RRT?
The byproduct of decreased tissue perfusion.
What is lactic acid?
If patient is hypotensive (MAP <65) after fluid resuscitation, this must be initiated.
What are vasopressors?
Early interventions for rhabdomyolysis.
What are fluids and hyperkalemia treatment?
Low blood pressure, bradycardia, diaphoresis, anxiety, altered mental status, cyanosis of lips or nails, and chest pain can all indicate this.
What is neurogenic shock?
Proper adherence to this reduces mortality associated with sepsis.
What is bundle compliance?