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Sepsis and SIRSMedical-Surgical Nursing-7th edition

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How is sepsis determined to be severe?
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Sepsis that leads to organ dysfunction or hypotension. It is the result of a failure of the cardiovascular system.
An increase in intracellular _________ causes stretching, cytokine and mediator release which then leads to local inflammation and eventually systemic inflammatory response syndrome (SIRS).
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Sodium
For a patient with sepsis, glucose levels should be maintained at?
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Less than 150
What compensatory measures seen during early sepsis fail as a patient progresses to septic shock?
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The cardiovascular response of systemic vasodilation to increase cardiac output.
What is systemic inflammatory response syndrome (SIRS)?
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A response to injury, ischemia, or pathogen which causes an inflammation in the organs
What is the leading non-coronary related cause of death in intensive care units?
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Sepsis (it is the 10th leadsing cause of death in the United States)
What is a hallmark sign of severe sepsis and/or septic shock?
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Refractory hypotension despite fluid resuscitation
Why is hypotension related to sepsis a late sign in infants and children when it is normally an early sign in adults?
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They maintain increased vascular tone longer than adults
How do you know by looking at a patient's medication list that they are severely septic?
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They are on both an antibiotic and vasopressors
What organs are typically the first to fail in a patient with sepsis?
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The lungs and the kidneys
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What types of septic patients should be given the medication Xigris?
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Adult patients with severe sepsis and an increased risk of infection, septic shock induced ARDS, septic shock or multiple organ dysfunction (MODS).
What is the main adverse reaction associated with Xigris?
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Bleeding
The best intervention for sepsis or multiple organ dysfunction is?.
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Prevention of infection
________ is usually the last organ to fail related to sepsis, however, if it has actually failed, the patient's death is virtually assured.
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The liver
How is Xigris, used in the treatment of severe sepsis, administered?
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Via continuous infusion over 96 hours. During this time, the patient cannot undergo any invasive procedures. If it is absolutely required, the infusion must be stopped.
What proinflammatory mediators are released during systemic inflammatory response syndrome?
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Cytokines including TNF, interleukins, and platelet activating factors as well as prostaglandins.
  
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