Final Blueprint Shock/Sepsis

Question 1

what is the patho of sepsis?

Answer 1

Infection occurs in the body (i.e. UTI, pneumonia, COVID)

Immune response is triggered (but gets out of control)

Inflammatory mediators and cytokines released into the blood which cause:
-Vasodilation: low volume
-Capillary leak: edema and low volume
-Blood clotting: blocked vessels

Organ damage occurs due to O2 starvation

Metabolic acidosis occurs due to organ disfunction (pH low; CO2, lactic acid, bicarb high)

Septic shock: when sepsis is resistant to fluid resuscitation (30mL/kg/H)

Multi-organ dysfunction syndrome: 2 or more organs have failed

Question 2

what are the nursing interventions for sepsis?

Answer 2

Rapid fluid bolus (30 mL/kg)

Draw blood cultures BEFORE starting ABX

Broad spectrum ABX until cultures are done

Vasopressors to maintain MAP >65

Passive leg raise

Question 3

what is shock?

Answer 3

decreased perfusion (hypotension - decreased CO - organ failure - death)

Question 4

what are the stages of shock?

Answer 4

Initial stage: not enough O2 to perfuse the organs, asymptomatic

Compensatory stage: HR and RR increase, renin and angiotensin released to try to balance, organs begin to fail

Progressive stage: progressive poor perfusion leads to cold and clammy skin

Irreversible stage: death

Question 5

What is sepsis shock?

Answer 5

Hypotension (SBP <90)

Cool and clammy skin - blood is being redirected to vital organs

Delayed cap refill

Mental status changes

Temp = very high or very low

Low urine output

WBC >10,000

Lactate >4