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Complex: Immune Adult
Terms in this set (45)
systemic inflammatory response syndrome
Widespread inflammation that can occur in patients with diverse disorders such as infection, trauma, shock, pancreatitis, or ischemia
ruber, calor, dolor, tumor
4 characteristics of the inflammatory process
Priority intervention when SIRS is identified
100.4, 96.8, 90, 20, 32, 12000, 4000, 10%
Clinical manifestations of SIRS: Temperature > ____ or < ____, heart rate > ____, respiratory rate > ____ or PaCO2 < ____, and white blood cell count > _______ or < _______ or > ______ immature band forms.
65-70, 110, pulmonary edema, 8, 65-70%
End points of fluid challenge: MAP ________, HR < _____, no _____________, CVP at least ____, and SvO2 ___________.
In a patient with SIRS, give _________ if pulmonary edema or liver failure occurs.
Best liver function determinate
infection, more than 2
To have sepsis, a patient must have a known or suspected _________ plus how many SIRS criteria?
To have ________ sepsis, a patient must have sepsis, MODS, and septic shock.
Stage ___ of SIRS occurs when the systemic response is associated with release of mediators or cytokins and increased recruitment of neutrophils and monocytes.
Stage ___ of SIRS occurs when there is a spill over of activated cytokines into the circulation but balance is retained by the dampening effects of anti-inflammatory cytokines.
Stage ___ of SIRS occurs when the balance is lost and there is a massive pro-inflammatory swing. There is generalized loss in capillary barrier function and generalized organ dysfunction.
Inflammatory response to microorganisms
Systemic inflammatory response to a clinical insult including infection, pancreatitis, ischemia, trauma, or hemorrhagic shock
Systemic response to infection manifested by two or more of the symptoms noted with SIRS
Sepsis associated with organ dysfunction
Sepsis with hypotension despite adequate fluid resuscitation along with perfusion abnormalities
Altered organ dysfunction in acutely ill patients such that homeostasis cannot be maintained without intervention
In MODS, each body system lost increases mortality by ______.
disseminated intravascular coagulation
Syndrome that arises as a complication of other serious or life-threatening conditions
PTT is ________ in DIC.
PT is _________ in DIC.
Thrombin time is _________ in DIC.
Fibrinogen is _______ in DIC.
Normal fibrinogen level
Fibrinogen degradation products is _________ in DIC.
Normal fibrinogen degradation product level
fibrinogen degradation product
Best indicator of DIC
Platelet count _________ in DIC.
Norma platelet count
D Dimer _________ in DIC.
Normal D Dimer level
Probability of clotting
In managing DIC, perform a platelet tranfusion if platelets fall below ________.
In managing DIC, administer cryoprecipitate if fibrinogen drops below ______.
In managing DIC, give fresh-frozen plasma if what 2 lab values are increased?
In managing DIC, inotropic agents and vasopressors are given with a _____ BP and to _______ MAP.
recombinant activated protein C
Given in managing DIC and especially in severe sepsis; acts as an anticoagulant and works to restore normal inhibition of coagulation pathways
Antidote for heparin
A heparin infusion is limited to how long before the risk for heparin-induced thrombocytopenia is greatly increased?
2 lab values that need to monitored when a patient is on heparin
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