What's going on here?
A systemic inflammatory response to an infection...
What is Sepsis
Blood Cultures must be drawn at this time.
What is Prior to administration of antibiotics.
The percentage of people who die annually in the US from sepsis once diagnosed.
What is 30-50%
An 80 yo woman with confusion and low temp better have you thinking about...
What is UTI and Sepsis.
Your 220 Lb septic patient is hypotensive, give them ____ amount of fluid.
What is 3L?
Why Lactic Acid elevates in Sepsis
What is Tissue Hypoperfusion.
The Lactic Acid level reaches this level to diagnose Sepsis.
What is 2?
This disease ranks #1 in healthcare costs in the U.S., inpatient mortality and is the #1 cause of readmissions.
What is Sepsis?
The 3 most common sources of infection that cause sepsis are...
What is UTI, Cellulitis and Pneumonia
____ fluids should be given to your septic patients.
What is crystalloid.
The cause of decreasing blood pressure in Sepsis?
What is Vasodilation
A patient arrives in the ED with tachycardia and tachypnea. A lactic acid level must be drawn initially within ____. If elevated repeat lactic acid levels must be drawn every ____.
What is 1 hour and every 2 hours until normalizing.
Mortality of all sepsis patients will increase if an RN delays this lifesaving stuff.
What are antibiotics...or crystaloids...or pressors.
This infection will show increased bilirubin.
What is Cholecystitis or Cholangitis?
This must be done prior to starting your IV antibiotics.
What is starting an IV!!!!
The most common organ to fail in Septic Shock.
What is Kidney Failure
Your patient has a 5% chance of surviving once this lactate level is reached.
What is 2?
The more of these that fail, the more likely your patient will die.
What is Organs/
The symptoms from this type of infection can mimic psychosis.
What is meningitis or encephalitis. Correct answer for extremely high fever or symptomatic hypotension.
If your patient's MAP is below ____ after giving appropriate fluid replacement volumes then start a pressor.
What is 65?
Four things that occur cellularly in the microvasculature during Septic Shock.
What is the glycocalyx which are proteins in the endothelium in capillaries regulates coagulation and inflammatory/anti-inflammatory signaling processes. In response to bacterial endotoxins, leukocytes move extracellular, edema increases, platelet adhesion/clot formation ALL DECREASE NORMAL BLOOD FLOW.
Give me 5 labs that could be altered with a sepsis diagnosis, and if they would be elevated or low.
What is WBCs up or down, Lactate elevated, platelets low, PT-PTT elevated, BUN-Creatinine elevated, liver enzymes ALT-AST elevated, CRP-PCT elevated, ABG low pH.
At noon my patient is doing poorly and has a 50% chance of dying from sepsis. I go on lunch break for an hour before I give the ordered antibiotic at 1300. My patient now has a ____ % chance of survival.
What is 40%? Every hour there is a 10% less chance of surviving severe sepsis.
You are caring for a 4 day post-op patient and it is Wednesday. Your focused assessment during your pt exam should include at the least these four things/actions.
What is remove dressing, observe for drainage, observe incision site wound edges, odor, redness, increasing pain, temp of surrounding skin.
Your patient is refractory to Norepinephrine and her BP is still too low. What is the best second pressor to hang?
What is Vasopressin? OK if you said epi gtt but vasopressin is preferred as it is not a chronotrope.