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24 Cards in this Set
- Front
- Back
Early indications for development of sepsis include:
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1. high temp
2. high HR 3. high respirations |
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T or F: septic shock is #1 cause of mortality in the ICU.
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true
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What are some factors that predispose to sepsis and septic shock?
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1. alteration in host defenses
2. severe underlying illnesses 3. major surgery 4. presence of foreign bodies 5. obstructive process 6. treatment with cytotoxic or anti-metabolites 7. prior antibiotic therapy |
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What is the chain of events that causes sepsis and septic shock?
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bacterial infection->bacteremia->inflammatory response->coagulation and decreased fibrinolysis->endothelial and vascular changes->hypoperfusion->organ failure
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What is the definition of SIRS? What are the s/s?
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1. systemic inflammatory response syndrome
2. 2 or more of the following: increased HR, temp, or respirations; changes in WBC count |
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Is SIRS always caused by infection?
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no
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If SIRS is caused by infection, what is this?
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sepsis
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What is sepsis syndrome?
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sepsis + evidence of altered organ perfusion
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From best to worst, what is the order of sepsis?
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bacteremia->SIRS->sepsis->sepsis syndrome->septic shock->multiple organ dysfunction syndrome
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What is septic shock?
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septis syndrome + refractory hypotension
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What is multiple organ dysfunction syndrome?
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altered organ function in acutely ill patient such that homeostasis cannot be maintained without intervention
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What bacteria are present in sepsis via UTI? Deep wounds? Nosocomial infections?
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1. e. coli, klebsiella
2. anaerobes (clostridium) 3. staph spp. |
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What are some common bacterial agents of sepsis?
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1. GNR
2. encapsulated pyrogens 3. staph spp. 4. beta-hemolytic strep 5. anaerobes |
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What is morphology for pseudomonas?
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GNR, oxidase +, non-fermenting, opportunistic pathogen
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What bacteria has a high mortality rate in sepsis?
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pseudomonas
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What patients might suffer from pseudomonas infection?
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1. burns
2. immunocompromised 3. hot tubs 4. neutropenia 5. nosocomial |
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Pseudomonas lesions in minority of patients are called what?
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ecthyma gangrenosum
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What are s/s of sepsis syndrome?
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1. apprehension
2. fever, chills (or hypothermia) 3. hyperventilation 4. hypotension 5. leukopenia or thrombocytopenia 6. altered organ function |
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Sequence of hemological events in sepsis?
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capillary leakage and vasodilation->hypotension (becomes refractory to fluid replacement)->hypoperfusion->end organ damage
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What are the key steps in the host inflammatory response in sepsis?
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pattern recognition receptors on host cells detect foreign antigen->this causes activation of TNF, IL-1, and HMGB1->endothelium activates->increases secretion of coagulation products->coagulation increases and fibrinolysis decreases->end organ damage
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What is protein C? What is PAI-1?
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1. anticoagulant that inhibits PAI-1
2. PAI-1 decreases fibrinolysis |
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T or F: septic patients are hyperglycemic.
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true
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What is one of the key treatments to stop septic shock from progressing?
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aggressive fluid replacement
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What organism would likely be found in a URI?
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strep pneumo
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