Lifespan 370: Test 3 Sirs, Sepsis, Mods

Front 1

The continuum?

Back 1

Infection -> sepsis -> severe sepsis -> septic shock -> MODS

Front 2

Systemic response to inflammation that may be triggered by trauma, abscesses, ischemic or necrotic tissue, infection, or decreased perfusion.

Back 2

Systemic Inflammatory response Syndrome (SIRS)

Front 3

What is the criteria for SIRS?

Back 3

Core temp >100.4 or <96.8
HR > 90-100
RR > 20 breaths/min
WBC > 10-12,000

Front 4

Sepsis def?

Back 4

Known or suspected infection plus 2 or more of the criteria for SIRS

Front 5

Severe sepsis def?

Back 5

Sepsis plus failure of 1 or more organ systems

Front 6

Septic shock def?

Back 6

Sepsis with persistent hypotension despite fluid resuscitation and vasopressor support

Front 7

Multiple Organ Dysfunction Syndrome (MODS) def?

Back 7

Presence of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention, most often caused by sepsis and severe sepsis

Front 8

Syndrome characterized by decreased tissue perfusion and impaired cellular metabolism?

Back 8

Shock

Front 9

How is blood flow characterized in septic shock?

Back 9

Maldistribution of blood flow

Front 10

What are the 3 stages of shock?

Back 10

1) Compensatory

2) Progressive

3) Refractory

Front 11

During the compensatory phase what happens to blood flow?

Back 11

Shunted away from non-essential organs

Front 12

Progressive stage of shock?

Back 12

Compensatory mechanisms fail

Begin to see symptoms in all organ systems

Pulmonary system (first big problem)

Front 13

What patients are at risk for shock?

Back 13

Weak immune system
surgery patients
Cancer patients
Elderly

Front 14

What are complications of fluid resuscitation?

Back 14

Hypothermia
Coagulopathhy

Front 15

How do you determine if fluid resuscitation has achieved end-organ perfusion?

Back 15

Urine output
Neuro function
Peripheral pulses

Front 16

What classes of drugs are used to treat shock?

Back 16

Vasopressors
Vasodialators

Front 17

Do you administer drugs or fluids first?

Back 17

Push fluids first and then drugs

Front 18

Vasopressors?

Back 18

Adrenalin
Levophed

Front 19

Vasodilators?

Back 19

Nipride
Nitroglycerin

Front 20

Drotrecogin alfa (Xigris) is an antibiotic used to treat septic shock that has what major side effect?

Back 20

Bleeding

Front 21

Shock nursing diagnosis?

Back 21

Ineffective tissue perfusion

Front 22

The focus of the collaborative management of septic shock is aimed toward?

Back 22

Finding and eradicating the cause of infection