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Sepsis
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Terms in this set (18)
SIRS-
Systemic inflammatory response
syndrome
whole body inflammatory
sepsis is SIRS from infection
...
severe sepsis is acute organ failure
...
Septic shock
persistently low MAP despite fluid resuscitation
Refractory septic shock
persistently low MAP despite fluid resuscitation AND vasopressors
Sepsis due to infection begins with septicemia
Portals of entry: urinary, respiratory, GI, integumentary, and female reproductive systems
Prevention
immunize against pneumonia
inf fm IV and catheters maj cause
Aseptic technique
hand washing
CM of sepsis
fever/hypothermia
tachycardia and tachypnea
(fast RR and HR)
peripheral vasodilation
septic shock
mental status changes
Lab results for sepsis
abn CBC
clotting factors
liver enzymes
Early septic shock (warm)
vasodilation --> hypotension --> fluid shifts, weakness, warm and flushed
septicemia- high fever chills
Late septic shock- cold
hypovolemia and compensatory mechanisms:
cold moist skin
oliguria
changes in mentation
death fm resp cardiac or renal failure
infants
temp instability
abdominal distention
poor feeding/lethargy
resp distress
hepatomegaly
vomiting
jaundice
elderly
decr SV, CO
decr compensatory resposes-thickened L vent. wall
decr elasticity of myocardium, rigid valves
Dx tests
Hgb Hct
ABGs
serum electrolytes
BUN creatinine
urine spec gravity
osmolality
blood cultures
WBC dif
serum enzymes
hemodynamic monitoring
X-ray, CT, MRI
gastric tonometry
sublingual PaCO2
Meds for bacterial or fungal cause
fluid replacement: vasoactive drgs
inotropic
O2 therapy
fluid replacement
assessment
v/s
hemodynamic monitoring= CVP, pulmonary artery catheter
monitor adequacy of renal, vent, perf
goals
> 30 mL urine/hr
O2>90
repsond to fluid resuscitation--> MAP in normal range
-skin
-BO
-RR
-lug sounds
pulse ox
peripheral pulse
-JVD
CVP measurements
-monitor temp
urinary outplut via foley hourly
assess mental status
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