NRSG 3200 Unit 9 Sepsis/SIRS(updated)2022

_____ is the most common type of distributive shock. Septic shock Sepsis life-threatening organ dysfunction caused by a dysregulated host response to infection 01:02 01:14 Septic Shock subset of sepsis in which underlying circulatory and cellular/metabolic abnormalities are profound enough to substantially increase mortality Older patients are at particular risk for sepsis because of... decreased physiologic reserves, an aging immune system, comorbid conditions and often nonspecific presentation of infection. Patients at risk for sepsis Immunosuppression Extremes of age (1 and 65) Malnourishment Chronic Illness (diabetes, hepatitis, kidney disease) Invasive procedures Emergent and/or multiple surgeries Burn patients Prevention of Sepsis Use strict infection control practice Hand hygiene Early removal of invasive devices that are no longer necessary Promote early ambulation Timely debriding of wounds to remove necrotic tissue Standard precautions Adhere to infection prevention/control practices Use aseptic technique Properly clean equipment and patient environment Systemic Inflammatory Response Syndrome (SIRS) a syndrome resulting from a clinical insult that initiates an inflammatory response that is systemic, rather than localized to the site of the insult. SIRS criteria Temperature 38.3 (101) or 36 (96.8) Tachycardia Tachypnea WBC 12,000 or 4,000 or 10% immature WBC (bands) Common infections that can lead to sepsis Lung infection UTIs GI infection Skin infection S/S of Sepsis Shivering, fever, or very cold Extreme pain or discomfort Clammy or sweaty skin Confusion or disorientation Shortness of breath High heart rate Sepsis Specific Labs Leukocytosis (WBC 12,000) Hyperglycemia (140) Elevated CRP Atrial hypoxemia Acute Oliguria (less than 0.5ml/kg/hr x2 hrs despite fluid resuscitation) Creatinine increase 0.5mg/dL Coagulation abnormalities Thrombocytopenia (100,000) Hyperbilirubinemia (total bilirubin 4 mg/dL) Adrenal insufficiency Hyperlactatemia (2 mmol/L). Elevated procalcitonin Clinical hypotension is defined as... a systolic BP below 90 or a decrease of 40 mmHg from baseline.