Pathophysiology
What is the primary cause of sepsis?
Answer: A dysregulated host response to an infection.
What is the earliest sign of sepsis in many patients?
Answer: Fever or hypothermia.
What is the first nursing priority when sepsis is suspected?
Answer: Early recognition and prompt intervention.
What is the first-line vasopressor used in septic shock?
Answer: Norepinephrine.
Mona, a 68-year-old with pneumonia, is febrile and tachycardic. What should be your first action?
Answer: Assess for signs of sepsis and initiate the sepsis protocol.
What inflammatory response leads to capillary leak and decreased perfusion in septic shock?
Answer: Systemic Inflammatory Response Syndrome (SIRS).
What respiratory pattern is commonly seen in early sepsis?
Answer: Tachypnea (rapid breathing).
What is the recommended fluid resuscitation rate for sepsis?
Answer: 30 mL/kg of IV crystalloids within the first 3 hours.
What is the preferred route for antibiotic administration in sepsis?
Answer: Intravenous (IV).
Mona’s BP drops to 82/54, and she becomes lethargic. What stage of sepsis is this?
Answer: Progressive stage of septic shock.
What happens to lactate levels in sepsis and why?
Answer: Lactate levels rise due to anaerobic metabolism from tissue hypoxia.
What happens to urine output in progressive septic shock?
Answer: It decreases due to impaired renal perfusion.
What is the target mean arterial pressure (MAP) in septic shock management?
Answer: ≥ 65 mmHg.
What laboratory marker is used to assess sepsis severity and guide resuscitation efforts?
Answer: Serum lactate.
Despite fluids, Mona’s MAP remains <65 mmHg. What is the next intervention?
Answer: Start norepinephrine to maintain perfusion.
Name the primary mechanism causing hypotension in septic shock.
Answer: Vasodilation and capillary permeability.
What skin changes may indicate worsening sepsis?
Answer: Cold, clammy skin or mottling.
What bedside maneuver can assess fluid responsiveness in sepsis?
Answer: Passive Leg Raise (PLR) test.
What intervention should be completed before starting antibiotics?
Answer: Obtain blood cultures.
Mona’s urine output is < 0.5 mL/kg/hr. What organ is failing?
Answer: The kidneys (acute kidney injury from sepsis).
What coagulation imbalance can occur in sepsis, leading to both clotting and bleeding?
Answer: Disseminated Intravascular Coagulation (DIC).
What neurological sign may indicate advancing septic shock?
Answer: Altered mental status (confusion, agitation, lethargy).
What sepsis screening tool is no longer recommended due to low sensitivity?
Answer: qSOFA score.
What are the five elements of the Surviving Sepsis Campaign 1-Hour Bundle?
Answer: 1) Measure lactate, 2) Obtain blood cultures, 3) Administer broad-spectrum antibiotics, 4) Begin rapid IV fluid resuscitation, 5) Administer vasopressors if needed.
Mona’s family is concerned about her worsening condition. What is a key nursing priority?
Answer: Provide clear, compassionate communication about her prognosis and treatment options.