Sepsis Patho
What is the body’s compensatory response to hypoperfusion?
SNS activation → tachycardia, vasoconstriction, increased RR.
What is the first-line treatment to restore perfusion in septic shock?
Rapid IV fluid resuscitation with crystalloids.
What drug counteracts bronchospasm during anaphylaxis?
Albuterol (bronchodilator).
Name the three stages of shock in order of progression.
Compensatory → Progressive → Irreversible
What auscultation finding develops as ARDS progresses?
Crackles
What does a high-pressure alarm on the ventilator indicate?
Increased airway resistance (e.g., kinked tubing, secretions, coughing, biting the tube).
What happens to tissue oxygen delivery during sepsis?
It decreases due to poor perfusion and oxygen extraction.
What certain physiologic responses are common in any type of shock?
↓ Tissue perfusion, ↓ oxygen delivery, tachycardia, tachypnea, vasoconstriction, and cellular hypoxia leading to lactic acidosis.
What is anaphylaxis?
A severe, life-threatening allergic reaction caused by rapid immune hypersensitivity.
What vital sign change is the earliest indicator of hypovolemic shock?
Tachycardia.
Which ABG value shows the greatest sign of respiratory failure?
High Pco2 (hypoxemia)
What is the nurse’s first action when any ventilator alarm sounds?
Assess the patient first, not the machine.
What is the main pathophysiologic mechanism behind sepsis-induced hypotension?
Widespread vasodilation and capillary permeability.
What nursing indicator often appears before vital sign changes in sepsis?
Altered mental status or confusion.
What happens to blood vessels during anaphylactic shock?
Massive vasodilation and capillary leak → hypotension.
What medication class helps improve contractility in cardiogenic shock?
Inotropes (e.g., dopamine, dobutamine).
What is the hallmark pathophysiologic feature of ARDS?
Increased capillary permeability leading to non-cardiogenic pulmonary edema.
How can the nurse confirm correct placement of an endotracheal tube immediately after insertion?
Auscultate bilateral breath sounds and observe chest rise; confirm with end-tidal CO₂ detector and chest X-ray.
What process leads to lactic acidosis in sepsis?
Anaerobic metabolism from cellular hypoxia.
What should the nurse monitor closely after fluid resuscitation?
Urine output, MAP, and lung sounds (for overload).
What is the first medication administered during anaphylactic shock?
Epinephrine (IM).
What is the priority nursing action for any type of shock?
Maintain airway and ensure adequate oxygenation.
Name one major precipitating cause of ARDS.
Sepsis, trauma, aspiration, pneumonia, or massive transfusion.
What nursing intervention reduces VAP risk?
Elevate HOB 30–45°, perform oral care, and use subglottic suctioning.
What causes septic shock?
Severe infection leading to systemic inflammatory response and widespread vasodilation.
What type of shock classification does sepsis fall under?
Distributive shock.
What IV fluid is used to support blood pressure in anaphylaxis?
Isotonic crystalloids (normal saline or lactated Ringer’s).
A trauma patient with massive blood loss develops hypotension and cold, clammy skin. After fluids, BP improves, but cardiac output drops and crackles develop. What two types of shock may be occurring?
Hypovolemic and cardiogenic shock (mixed shock state).
Why is PEEP used in the management of ARDS, and what risk must the nurse closely monitor for?
PEEP keeps alveoli open and improves oxygenation by preventing collapse at end-expiration, but excessive PEEP can cause barotrauma and hypotension due to decreased venous return.
The nurse is caring for a patient on a ventilator receiving midazolam (Versed) and vecuronium. What is the nurse’s top priority?
Ensure sedation is adequate before giving paralytics and maintain ventilator and airway security, since the patient cannot breathe independently or communicate.