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Clinical Decision Making Exam 1 > Sepsis Questions > Flashcards

Sepsis Questions Flashcards

1
Q

3 signs of septic shock

A

need for meds to maintain SBP 65 or higher

serum lactate > 18

above sx despite adequate volume resuscitation

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2
Q

lactic acid is a byproduct of __

that is produced during __

A

pyruvate

glycolysis

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3
Q

lactate is a measure of

A

low O2 → anaerobic metabolism

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4
Q

why is lactate elevated in sepsis

A

bp drop → decreased perfusion/O2 delivery → anaerobic environment → increased lactate

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5
Q

sepsis is a vicious cycle of hypo__

and hypo__

A

hypotn

hypoperfusion

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6
Q

in response to hypotn and hypoperfusion, the body releases __

in order to maintain tissue perfusion

A

epi

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7
Q

exaggerated response to infxn

A

SIRS

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8
Q

2 diagnostic criteria for sepsis

A

SIRS

PLUS

infxn

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9
Q

what is used as early recognition to make dx and guide intervention in sepsis

A

SIRS criteria

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10
Q

typical vital signs w. sepsis

A

sx/signs specific to infxn

arterial hypotn

temp: > 38.3C or < 36C

HR > 90

RR > 20 bpm

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11
Q

signs of end-organ perfusion

A

warm, flushed skin

AMS, restlessness

oliguria/anuria

ileus/absent BS

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12
Q

tx for PNA induced sepsis

A

pip-taz

PLUS

vanco

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13
Q

tx for UTI induced sepsis

A

pip-taz

PLUS

vanco

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14
Q

tx for cellulitis induced sepsis

A

vanco

PLUS

cefazolin

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15
Q

why would you add tobramycin to sepsis tx

A

suspect p. aeruginosa

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16
Q

mainstay abx tx for sepsis

A

pip-taz

PLUS

vanco

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17
Q

abx timing if sepsis is definite

A

immediately - w.in 1 hr

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18
Q

abx timing if sepsis probable + shock

A

immediately - w.in 1 hr

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19
Q

abx timing if sepsis and NO shock

A

rapidly assess

administer w.in 3 hr

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20
Q

biomarker for systemic bacterial infxn and sepsis

useful for determining bacterial etiology for sepsis

A

procalcitonin

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21
Q

when should procalcitonin decrease

A

after abx administration

22
Q

does level of PCT correlate w. severity of infxn

A

yep!

23
Q

t/f: PCT can be used to help determine when to deescelate abx

A

T!

24
Q

when obtaining blood cultures, what 2 types of samples should you collect

A

aerobic

anaerobic

25
Q

how many sets of each type of sample should you collect

A

at least 2 sets from 2 different sites

26
Q

when should blood cultures be collected

A

before initiating abx

27
Q

bottom of vial on blood culture turns green, what does this mean

A

no growth

28
Q

bottom of via on blood sample turns orange, what does this mean

A

growth

29
Q

how is gram staining done

A

glass slide prepared w. culture from vial → microscopy

30
Q

what lines should not be used for culture samples

A

peripheral

central (PICC)

31
Q

plasma volume expanding solute that contains electrolytes

A

crystalloids

32
Q

2 ex of crystalloids

A

LR

D5W

33
Q

2 s.e of crystalloids

A

edema

acidosis

34
Q

what is a balanced/buffered crystalloid

A

isotonic solute containing lytes buffered w. Cl

35
Q

3 benefits of balanced crystalloid

A

restores lyte balance

maintains normal pH

hydration

36
Q

solute containing large proteins like albumin

remains intravascular to draw water from cells into intravascular space

A

colloids

37
Q

benefit of colloids

A

significantly increases volume

but can dehydrate cells

38
Q

which lasts longer: crystalloids or colloids

A

crystalloids

albumin has shorter half life

39
Q

fluid of choice in sepsis

A

crystalloids

40
Q

what is MAP

A

average bp during single cardiac cycle

41
Q

how is MAP measured

A

systolic and diastolic pressure readings

42
Q

MAP =

A

(CO x SVR) + (CVP)

43
Q

simple MAP calculation

A

MAP = (SBP + (2 x DBP)) / 3

44
Q

how is ABP measured

A

intra-arterial catheter

45
Q

how is CVP measured

A

vena cava catheter

46
Q

3 main bacteria associated w. newborn sepsis

A

e.coli

GBS

listeria

47
Q

2 bacteria responsible for early and late onset sepsis in neonates

A

e.coli

GBS

48
Q

neonatal sepsis occurs in infants

A

90 days old

49
Q

bacteria associated w. sepsis in IVDU

A

MRSA

also MSSA and GAS

50
Q

besides MRSA, what can be another source of sepsis in IVDU

A

HIV

  • sepsis alliance*
  • mc cause of death in HIV pt’s*

Clinical Decision Making Exam 1 (22 decks)

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