NRl 572/l NR572l Midterml Exam:l
Advancedl Acutel Carel Managementl Guidel
(Latestl 2026/l 2027l Update)l |l Qsl &l As|l
Gradel A|l 100%l Correctl (Verifiedl
Answers)-l Chamberlain
QUESTION
Sepsis
Answer:
l Al life-threateningl organl dysfunctionl causedl byl al regulatedl hostl inflammatoryl responsel
tol infectionl suspectedl orl confirmed.l
Organl dysfunctionl :l hypotension,l confusion,l delirium,l hypoxemia,l respiratoryl failure,l
oliguria,l elevated,l creatinine,l liverl failure,l ileus,l sepsis-l induced,l cardiomyopathy,l
coagulopathy,l leukocytosis,l thrombocytopenia,l skinl mottling,l etc.
QUESTION
Septicl shock
Answer:
l Al subsetl ofl sepsisl inl whichl particularlyl profoundl circulatory,l cellular,l andl metabolicl
abnormalitiesl arel associatedl withl al greaterl riskl ofl mortalityl thanl withl sepsisl alone.
Distributivel shock
QUESTION
Differentialsl forl sepsis
Answer:
l AKI,l ARDS,l adrenall crisis,l cardiogenic,l hemorrhagic,l orl hypovolemicl shock,l MI,l
anaphylacticl reaction,l PE,l DKA,l salicylatel toxicity,l toxicl shockl syndrome,l toxicl
epidermall necrolysisl (TEN),l thyrotoxicosis
,QUESTION
Diagnosticsl forl sepsis
Answer:
l Twol setsl ofl bloodl culturesl (anaerobicl andl aerobicl froml twol differentl sites)
Chestl x-rayl (pulmonaryl edema,l pneumonia,l ARDS)
Urine,l sputum,l andl otherl culturesl
EKGl (arrhythmias,l ischemia,l infarction)
2Dl echol (valve,l vegetation,l cardiacl output)
Diagnosticl imagingl forl infectiousl sourcel andl abdomenl
CSFl analysisl (ventriculostomy,l ventriculoperitoneall shunt/VPl shunt)
Procalcitoninl (associatedl withl bacteriall infectionl andl sepsis)
Cl reactivel proteinl
CBCl withl differentiall (anemia,l thrombocytopenia,l leukocytosisl withl bandemia)
Metabolicl panell (AKI,l anionl gapl acidosis,l hyperglycemia,l hyperbilirubinemia)
Seruml lactatel (>4mmol/Ll consistentl withl systemicl hypol perfusion)
ABGl (PaO2,l PaCO2,l pH)
Bloodl culturel froml CVCl ifl presentl tol assessl forl catheterl relatedl sepsisl
Disseminatedl intravascularl coagulationl panell (DIC)-l INR,l aPTT,l fibrinogen
*Seruml lactate-l >4mmoll =l systemicl hypoperfusion*
QUESTION
Septicl shockl diagnosticl criteria
Answer:
l 1)l Persistentl hypotensionl requiringl vasopressorsl tol maintainl MAPl greaterl thanl 65
2)l Elevatedl seruml lactatel levell despitel adequatel fluidl resuscitationl (>2)
Lacticl acidosisl isl perilous!l =l MODSl andl deathl ifl tissuel hypoperfusionl froml septicl
shockl continuesl orl worsens=l increasedl lacticl acidosis
QUESTION
MODS
Answer:
,l Multiplel systeml organl dysfunctionl syndrome
Assessmentl toolsl :
Sequentiall organl failurel assessmentl (SOFA)
Quickl SOFAl (qSOFA)
Usedl tol clinicallyl categorizel clientsl withl sepsisl andl organl dysfunction
QUESTION
SOFA
Answer:
l Sequentiall (sepsisl related)l Organl Failurel Assessment:
-gradesl functionl ofl sixl organl systemsl onl al scalel ofl 0-4
-basedl onl thel degreel ofl dysfunctionl usingl objectivel measurements
-al scorel ofl twol orl morel pointsl meetsl thel criterial forl organl dysfunction
-Asl thel scorel increases,l hospitall mortalityl increases
-requiresl ABGl andl seruml bloodl workl results
QUESTION
qSOFAl score
Answer:
l H-l hypotension
A-l alteredl mentall status
T-l tachypnea
Presencel ofl 2l criterial (1l pointl each):
GCSl <15,l RRl >22,l SBPl <100
Scorel >2l inl non-icul patientsl associatedl withl significantlyl increasedl hospitall mortality.
QUESTION
Septicl shockl treatment
Answer:
, l Tissuel oxygenationl isl lacticl acidsl kryptonite!
Securel airway,l ensurel adequatel ventilation,l establishl reliablel IVl access,l initiatingl fluid,l
resuscitation,l transportingl patientl tol appropriatel levell ofl carel shouldl occurl rapidly.
Decision-makingl andl treatmentl benchmarksl arel informedl byl thel survivingl sepsisl
campaign'sl (SSC)l internationall guidelinesl forl thel managementl ofl sepsisl andl septicl
shock,l 2016.
QUESTION
SSC'sl Hour-1l Bundle
Answer:
l Froml thel survivingl sepsisl campaign'sl (SSC)l Internationall Guidelinesl forl thel
Managementl ofl Sepsisl andl Septicl Shock
Includesl fivel criticall stepsl thatl shouldl bel initiatedl withinl thel firstl hourl froml initiall
contactl ofl patientsl withl clinicall suspicionl forl sepsisl :
1)l measurel seruml lactate(remeasurel ifl thel initiall levell is>2mmol/L)
2)l obtainedl bloodl culturesl beforel administeringl antibiotics
3)l administerl broad-spectruml antibiotics
4)l beginl rapidl administrationl ofl crystalloids(30ml/kg)l ifl seruml lactatel isl >4l orl ifl
hypotensionl exists
5)l utilizel vasopressorsl forl hypotensionl duringl orl afterl fluidl resuscitationl tol maintainl anl
MAPl >l 65
QUESTION
Sepsisl awarenessl andl prevention
Answer:
l Carel forl chronicl conditions,l getl recommended,l vaccines,l keepl cuts,l andl scratches,l
cleanl andl coveredl untill whilel healed,l washl hands,l wearl al mask
TIMEl acronyml forl whenl tol seekl immediatel care:
Temperaturel -l higherl orl lowerl thanl normal
Infection-l signsl orl symptomsl ofl infection
Mentall declinel -l confuse,l sleepy,l orl difficultl tol arouse
Advancedl Acutel Carel Managementl Guidel
(Latestl 2026/l 2027l Update)l |l Qsl &l As|l
Gradel A|l 100%l Correctl (Verifiedl
Answers)-l Chamberlain
QUESTION
Sepsis
Answer:
l Al life-threateningl organl dysfunctionl causedl byl al regulatedl hostl inflammatoryl responsel
tol infectionl suspectedl orl confirmed.l
Organl dysfunctionl :l hypotension,l confusion,l delirium,l hypoxemia,l respiratoryl failure,l
oliguria,l elevated,l creatinine,l liverl failure,l ileus,l sepsis-l induced,l cardiomyopathy,l
coagulopathy,l leukocytosis,l thrombocytopenia,l skinl mottling,l etc.
QUESTION
Septicl shock
Answer:
l Al subsetl ofl sepsisl inl whichl particularlyl profoundl circulatory,l cellular,l andl metabolicl
abnormalitiesl arel associatedl withl al greaterl riskl ofl mortalityl thanl withl sepsisl alone.
Distributivel shock
QUESTION
Differentialsl forl sepsis
Answer:
l AKI,l ARDS,l adrenall crisis,l cardiogenic,l hemorrhagic,l orl hypovolemicl shock,l MI,l
anaphylacticl reaction,l PE,l DKA,l salicylatel toxicity,l toxicl shockl syndrome,l toxicl
epidermall necrolysisl (TEN),l thyrotoxicosis
,QUESTION
Diagnosticsl forl sepsis
Answer:
l Twol setsl ofl bloodl culturesl (anaerobicl andl aerobicl froml twol differentl sites)
Chestl x-rayl (pulmonaryl edema,l pneumonia,l ARDS)
Urine,l sputum,l andl otherl culturesl
EKGl (arrhythmias,l ischemia,l infarction)
2Dl echol (valve,l vegetation,l cardiacl output)
Diagnosticl imagingl forl infectiousl sourcel andl abdomenl
CSFl analysisl (ventriculostomy,l ventriculoperitoneall shunt/VPl shunt)
Procalcitoninl (associatedl withl bacteriall infectionl andl sepsis)
Cl reactivel proteinl
CBCl withl differentiall (anemia,l thrombocytopenia,l leukocytosisl withl bandemia)
Metabolicl panell (AKI,l anionl gapl acidosis,l hyperglycemia,l hyperbilirubinemia)
Seruml lactatel (>4mmol/Ll consistentl withl systemicl hypol perfusion)
ABGl (PaO2,l PaCO2,l pH)
Bloodl culturel froml CVCl ifl presentl tol assessl forl catheterl relatedl sepsisl
Disseminatedl intravascularl coagulationl panell (DIC)-l INR,l aPTT,l fibrinogen
*Seruml lactate-l >4mmoll =l systemicl hypoperfusion*
QUESTION
Septicl shockl diagnosticl criteria
Answer:
l 1)l Persistentl hypotensionl requiringl vasopressorsl tol maintainl MAPl greaterl thanl 65
2)l Elevatedl seruml lactatel levell despitel adequatel fluidl resuscitationl (>2)
Lacticl acidosisl isl perilous!l =l MODSl andl deathl ifl tissuel hypoperfusionl froml septicl
shockl continuesl orl worsens=l increasedl lacticl acidosis
QUESTION
MODS
Answer:
,l Multiplel systeml organl dysfunctionl syndrome
Assessmentl toolsl :
Sequentiall organl failurel assessmentl (SOFA)
Quickl SOFAl (qSOFA)
Usedl tol clinicallyl categorizel clientsl withl sepsisl andl organl dysfunction
QUESTION
SOFA
Answer:
l Sequentiall (sepsisl related)l Organl Failurel Assessment:
-gradesl functionl ofl sixl organl systemsl onl al scalel ofl 0-4
-basedl onl thel degreel ofl dysfunctionl usingl objectivel measurements
-al scorel ofl twol orl morel pointsl meetsl thel criterial forl organl dysfunction
-Asl thel scorel increases,l hospitall mortalityl increases
-requiresl ABGl andl seruml bloodl workl results
QUESTION
qSOFAl score
Answer:
l H-l hypotension
A-l alteredl mentall status
T-l tachypnea
Presencel ofl 2l criterial (1l pointl each):
GCSl <15,l RRl >22,l SBPl <100
Scorel >2l inl non-icul patientsl associatedl withl significantlyl increasedl hospitall mortality.
QUESTION
Septicl shockl treatment
Answer:
, l Tissuel oxygenationl isl lacticl acidsl kryptonite!
Securel airway,l ensurel adequatel ventilation,l establishl reliablel IVl access,l initiatingl fluid,l
resuscitation,l transportingl patientl tol appropriatel levell ofl carel shouldl occurl rapidly.
Decision-makingl andl treatmentl benchmarksl arel informedl byl thel survivingl sepsisl
campaign'sl (SSC)l internationall guidelinesl forl thel managementl ofl sepsisl andl septicl
shock,l 2016.
QUESTION
SSC'sl Hour-1l Bundle
Answer:
l Froml thel survivingl sepsisl campaign'sl (SSC)l Internationall Guidelinesl forl thel
Managementl ofl Sepsisl andl Septicl Shock
Includesl fivel criticall stepsl thatl shouldl bel initiatedl withinl thel firstl hourl froml initiall
contactl ofl patientsl withl clinicall suspicionl forl sepsisl :
1)l measurel seruml lactate(remeasurel ifl thel initiall levell is>2mmol/L)
2)l obtainedl bloodl culturesl beforel administeringl antibiotics
3)l administerl broad-spectruml antibiotics
4)l beginl rapidl administrationl ofl crystalloids(30ml/kg)l ifl seruml lactatel isl >4l orl ifl
hypotensionl exists
5)l utilizel vasopressorsl forl hypotensionl duringl orl afterl fluidl resuscitationl tol maintainl anl
MAPl >l 65
QUESTION
Sepsisl awarenessl andl prevention
Answer:
l Carel forl chronicl conditions,l getl recommended,l vaccines,l keepl cuts,l andl scratches,l
cleanl andl coveredl untill whilel healed,l washl hands,l wearl al mask
TIMEl acronyml forl whenl tol seekl immediatel care:
Temperaturel -l higherl orl lowerl thanl normal
Infection-l signsl orl symptomsl ofl infection
Mentall declinel -l confuse,l sleepy,l orl difficultl tol arouse
