CDM Exam 4 Solved 100% Correct

Patho of Sepsis (7 steps) - ANSWER-1) Body's immune response is triggered 2) White blood cells come to help (inflammatory mediators, interferons, cytokines, and histamine) 3) Vasodilation, capillary leak, and blood clotting 4) There is not enough blood flow to the organs (BIG PROBLEM) 5) Metabolic acidosis (due to organs not getting enough O2) 6) Septic shock (pt is not responding to fluid treatment) 7) MODS (multiple organ dysfunction syndrome) (two or more organs have failed) Fluid Resuscitation with Sepsis - ANSWER-Give 30 mL of fluid per kg of body weight (Stronger meds will be given if not responding. Occurs if pt advances to septic shock) Why do patients need vasopressors during Septic Shock? - ANSWER-When a patient is having persistent hypotension that isn't responding to fluid, needs vasopressors to maintain MAP 65, and lactate 2 mmol/L Examples of Vasopressors - ANSWER--*Norepinephrine (1st choice of tx for septic shock)* -Epinephrine -Vasopressin -Dopamine *These CONSTRICT blood vessels to raise BP!* Which complication can occur due to the norepinephrine requiring close observation while on the medication? - ANSWER-*Peripheral tissue necrosis!* -Infiltration of norepinephrine: tissue ischemia and necrosis of affected area -Must check IV site hourly -Must be given in large vessel (want blood to help cover this drug to prevent destruction of vessel) What assessments must you perform with norepinephrine admin? - ANSWER-1) Cap refill 2) ALL pulses 3) Skin temp 4) Ability to move finger/toes 5) Sensation (soft/hard) 6) LOC 7) UO MAP - ANSWER-Mean arterial pressure -Normal: 65-100 -The average pressure in a patient's arteries during one cardiac cycle -*Best indicator of perfusion in the body*