Definitions
The presence of bacteria in the bloodstream
Bacteremia
True or false: Invasive lines, surgery, catheters, and immunosuppressive therapy can put a patient at risk for sepsis
True
A blood pressure of 80/45 indicates the patient is?
Hypotensive
***Released by immune cells, these peptide factors have signaling, inflammatory, growth, and inhibitory functions
Cytokines
What is a patient with a temperature of 38.1C and a HR of 124 undergoing?
A systemic inflammatory response (SIRS)
The body's protective response at the site of injury or tissue destruction
Inflammation
A set of guidelines established in order to properly treat and manage patient's with severe sepsis or septic shock
Sepsis bundle
How soon should antibiotic therapy begin once sepsis is diagnosed?
1 hour
List at least two structures of the immune system
1) Skin & mucous membranes 2) mononuclear phagocyte system 3) Lymphoid system 4) bone marrow
List at least two signs/symptoms that a patient might exhibit if they are septic
Altered mental status, low blood pressure, elevated HR, elevated temperature or very low temperature, increased respirations, lethargy
SIRS with known infection
Sepsis
Sepsis can affect people of all ages, but this group of people is at higher risk
The elderly (65 years of age)
True or false: 1.7 million people per year are diagnosed with sepsis?
True
A mature monocyte and phagocyte that secrete cytokines and stimulate inflammation
Macrophage
If a patient's blood pressure does not increase after fluid resucitation, what class of medication may be initiated?
Vasopressors
Failure of two or more organ systems requiring additional interventions to maintain function
Multiple organ dysfunction syndrome (MODS)
There are multiple complications of septic shock, name at least one
ARDS, DIC, Acute renal failure, MODS
When a patient present with severe sepsis, their chances of survival decrease by almost 8% for every ____ that goes by without treatment
***A "shift to the left" refers to an increase in what type of cell?
Immature (band) neutrophils
When should a Vancomycin trough be drawn?
Before the 4th dose
Used to assess the acid-base state and adequacy of tissue perfusion
Lactate level
***Sepsis is a form of which type of shock?
Distributive
What is the normal range for a lactate level?
0.7-2.0 mmol/L
What is released into the host's blood stream during bacterial cell lysis?
Endotoxins
Lab results indicate low platelet and fibrinogen levels, but an elevated D-dimer. What complication of shock are you concered about?
DIC