Sepsis, SIRS, MODS
This term describes life‑threatening organ dysfunction caused by a dysregulated host response to infection.
What is sepsis?
This is the formula for cardiac output.
What is CO = HR × SV?
Shock begins when tissue perfusion is insufficient to meet what essential cellular need?
What is oxygen delivery?
This vasoactive medication can be used to decrease preload for patients with cardiogenic shock. It is contraindicated for patients who have taken phosphodiasterase inhibitor (PDE‑5) within 24 hours and commonly causes headaches.
What is nitroglycerin
This broad type of shock causing relative hypovolemia.
What is distributive shock?
An acute rise of this score by ≥2 indicates organ dysfunction under Sepsis‑3.
What is the SOFA score?
The bedside perfusion target for shock resuscitation is a MAP of at least this value.
What is 65 mmHg?
Stage of shock where mechanisms such as SNS, RAAS are triggered to maintain blood pressure despite falling perfusion.
What is the compensatory stage?
Fixed‑dose add‑on pressor (vasoconstrictor) in septic shock (not titrated) that is added in addition to norepinephrine infusion.
What is vasopressin?
Tension pneumothorax, cardiac tamponade, and massive pulmonary embolism cause this type of shock.
What is obstructive shock?
Name at least 2 populations at risk for sepsis
Older adults (>65), infants (<1), chronic disease, immunosuppressed, recent surgery/hospitalization, pregnancy/postpartum)?
State one bedside cue of poor perfusion besides MAP
cool/mottled skin, cap refill delay, oliguria, altered mentation).
MAP <65, rising lactate, worsening mentation, cold skin, and falling UOP all indicate failure of what essential physiologic process?
What is tissue perfusion?
Inotrope used when stroke volume/CO remain low despite MAP ≥65; watch for tachyarrhythmias.
: What is dobutamine
Massive vasodilation with bradycardia and warm, dry skin points to this shock which occurs with high spinal cord injuries (T4)
What is neurogenic shock
An elevated value of this blood marker (>2 = sepsis, >4 = high mortality risk) indicates tissue hypoperfusion.
What is lactate?
Identify one determinant of stroke volume and how it changes SV
What is preload, contractility, or afterload?
Profound hypotension unresponsive to fluids and vasopressors, severe cellular hypoxia, and multi‑organ failure characterize this terminal shock stage.
What is the refractory (irreversible) stage?
Which antibiotic class must be monitored for tendon rupture?
What is fluoroquinolone (Levafloxacin)?
Airway edema/bronchospasm + urticaria/angioedema + distributive physiology define this emergency.
What is anaphylactic shock?
What happens with sepsis?
It is a dysregulated systemic inflammatory response (cytokine storm).
This invasive line provides continuous BP, allows ABG sampling, and must be leveled to the phlebostatic axis.
What is an arterial line?
Name two high‑yield early nursing actions in suspected sepsis prior to antibiotics.
What are draw cultures and measure lactate (and start crystalloids if hypotensive/high lactate)?
Preferred therapy for ESBL‑producing gram‑negatives causing sepsis.
What is a carbapenem (e.g., meropenem)
High PAWP, pulmonary crackles, cool extremities, narrow pulse pressure, and low CO indicate this specific type of shock.
What is cardiogenic shock?
What are at least two of the findings required for SIRS (Systemic Inflammatory Response Syndrome)?
This syndrome requires at least two findings: fever/hypothermia, tachycardia, tachypnea/hypocapnia, or abnormal WBC count.
PA (pulmonary artery) catheter metric that estimates left‑sided preload.
What is PAWP (pulmonary artery wedge pressure)
Trend this biomarker every 2–4 hours early; a 10–20% drop per interval signals improving perfusion.
What is lactate?
This is primarily alpha 1 agonist (vasoconstriction) used for neurogenic shock.
What is phenylephrine?
SBP ≤100 and RR ≥22 with fever/hypothermia flag early concern for what condition?
What is sepsis (possible septic shock)?
MODS is diagnosed when at least how many organ systems fail?
What is two or more?
This dynamic bedside maneuver transiently “auto‑transfuses” ~150–500 mL to test fluid responsiveness.
What is the passive leg raise (PLR) test?
Procalcitonin is a peptide in the body that is a part of the response to bacterial infection. What happens to the levels of PCT in response to bacterial infection?
Elevated
Infuse this glycopeptide over ≥60 min to reduce “red‑man” infusion reaction; monitor AUC and renal function.
What is vancomycin?
What are the three types of distributive shock?
Neurogenic, anaphylacic, septic
SIRS can be triggered by infection or noninfectious insults. Name one noninfectious trigger from your notes.
What is trauma/burns, pancreatitis, ischemia/MI, surgery, or endotoxin‑independent inflammation
Name two nursing must‑dos to keep invasive pressure monitoring accurate (e.g., a‑line/PA line).
Level & zero to the phlebostatic axis
Maintain the 300 mmHg pressure bag
Assess waveform quality
Assess and maintain site
In ARDS, the PaO₂/FiO₂ ratio falls below this cutoff, indicating impaired gas exchange.
What is <300?
Potent balanced vasodilator used for afterload (± preload) reduction in cardiogenic states only if MAP is adequate; protect from light—risk of cyanide/thiocyanate toxicity.
What is sodium nitroprusside?
What are three (3) causes of hypovolemic shock?
Hemorrhage from a variety of causes
Other fluid losses like dehydration from vomiting diarrhea, lack of intake heat exposure, fever, etc.
Burns, which cause fluid to leak from damaged skin into surrounding tissues.
Nutritional hypoalbuminemia, where low protein levels reduce fluid retention in blood vessels, causing fluid to accumulate in tissues.