Sepsis Clinical Management Quiz
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Questions and Answers

What is the primary effect of an excessive immune response in sepsis?

  • Increased blood flow to organs
  • Reduced white blood cell count
  • Increased capillary permeability (correct)
  • Enhanced local immune activity

What is the primary goal for maintaining SpOâ‚‚ levels in clinical management?

  • Enhance oxygen delivery to tissues (correct)
  • Minimize blood pressure
  • Prevent respiratory distress
  • Reduce heart rate

What occurs when the body experiences reduced blood flow to organs during sepsis?

  • Increased aerobic respiration
  • Improved tissue perfusion
  • Metabolic acidosis due to lactic acid buildup (correct)
  • Enhanced clot formation

Which of the following is a broad-spectrum antibiotic mentioned in clinical management?

<p>Ceftriaxone (B)</p> Signup and view all the answers

What initiates the formation of micro clots in the context of sepsis?

<p>Extrinsic clotting cascade activation (D)</p> Signup and view all the answers

How does the body respond to hypotension during sepsis?

<p>By releasing adrenaline (A)</p> Signup and view all the answers

What is the role of the ODP in recognizing sepsis?

<p>Perform an A-E assessment (D)</p> Signup and view all the answers

What is the fluid challenge volume and rate mentioned for establishing fluid therapy?

<p>500 ml of Saline over ≤15 min (A)</p> Signup and view all the answers

What leads to multiple organ failure in sepsis?

<p>Switching to anaerobic respiration (D)</p> Signup and view all the answers

What is the significance of measuring lactate levels in clinical management?

<p>To evaluate the degree of acidosis (C)</p> Signup and view all the answers

What respiratory rate indicates a potential red flag for sepsis or shock?

<p>25/min (A)</p> Signup and view all the answers

Which of the following is a component of the Sepsis 6 protocol?

<p>IV fluids for fluid loss replacement (D)</p> Signup and view all the answers

What is the minimum urine output aimed for to ensure kidney perfusion in a patient?

<p>0.5 mLs/kg/hour (B)</p> Signup and view all the answers

Which factor is NOT one of the three main components needed for effective blood flow?

<p>Effective Nervous System (D)</p> Signup and view all the answers

What does a decreased systolic BP of 40 mm Hg less than baseline indicate?

<p>Possible shock or sepsis (D)</p> Signup and view all the answers

What is a key characteristic of sepsis?

<p>It results from the body's response to an infection. (B)</p> Signup and view all the answers

Which symptom is NOT typically associated with sepsis?

<p>High blood pressure (B)</p> Signup and view all the answers

In the A-E assessment, which finding is indicative of respiratory distress in sepsis?

<p>Tachyapnea with low SpO2 (D)</p> Signup and view all the answers

Which medication is recommended to increase vascular resistance in septic shock?

<p>Norepinephrine (D)</p> Signup and view all the answers

What population is at a higher risk for experiencing shock?

<p>Patients with cardiovascular issues (B)</p> Signup and view all the answers

What is the effect of adrenaline on the heart regarding its rate and contraction force?

<p>Increases heart rate and increases force of contraction (C)</p> Signup and view all the answers

What happens to the arteries when adrenaline binds to alpha-1 receptors?

<p>They constrict, reducing blood flow (D)</p> Signup and view all the answers

In the provided blood gas analysis, which test value indicates acidosis?

<p>pH of 7.23 (D)</p> Signup and view all the answers

What might be inferred from a low PaCO2 value of 3.2 kPa in the blood gas analysis?

<p>Patient is likely hyperventilating (C)</p> Signup and view all the answers

What is the metabolic problem indicated by a low HCO3 value of 12.6 mmol/l?

<p>Metabolic acidosis (C)</p> Signup and view all the answers

What is the primary purpose of administering oxygen in this scenario?

<p>To maintain SpO2 above 94% (A)</p> Signup and view all the answers

Why should Compound Sodium Lactate (Hartmann's) not be administered?

<p>It contains lactate, which is already high due to metabolic acidosis (B)</p> Signup and view all the answers

What should be done first when initiating antibiotic therapy?

<p>Give broad spectrum IV antibiotics (A)</p> Signup and view all the answers

What role does Noradrenaline play in this treatment plan?

<p>It increases the tone of the vessels by acting on α1 receptors (D)</p> Signup and view all the answers

Why is measuring urine output important during sepsis management?

<p>To monitor renal function, which is often limited (A)</p> Signup and view all the answers

What is the main cause of sepsis symptoms in the body?

<p>Immunological overactivity due to excess leukocytes (A)</p> Signup and view all the answers

Which of the following is a physiological effect of sepsis?

<p>Decreased urine output (C)</p> Signup and view all the answers

Which treatment should be administered within the first hour of recognizing sepsis?

<p>Broad spectrum antibiotics (A), Intravenous fluids (B), Blood cultures (C)</p> Signup and view all the answers

What causes the increased heart rate commonly observed in sepsis?

<p>Adrenaline release causing vascular dilation (C)</p> Signup and view all the answers

Which condition is indicated by decreased capillary refill time in a patient with sepsis?

<p>Decreased perfusion to tissues (B)</p> Signup and view all the answers

What change in metabolic activity occurs as a response to sepsis?

<p>Increased anaerobic metabolism (B)</p> Signup and view all the answers

What is a sign of multi-organ failure in sepsis?

<p>Decreased urine output (D)</p> Signup and view all the answers

Which symptom may indicate a seriously progressed case of sepsis?

<p>Cyanosis of lips and tongue (C)</p> Signup and view all the answers

Flashcards

Oxygen Administration for Sepsis

Administer oxygen to a patient aiming to maintain their blood oxygen saturation at 94% or higher.

Blood Culture in Sepsis

Draw blood samples for bacterial culture to identify the specific organism causing the infection.

Fluid Challenge in Sepsis

Deliver a large volume of IV saline solution (500 ml) rapidly (within 15 minutes) to restore fluid balance and improve blood circulation.

Lactate Measurement in Sepsis

Measure the lactate level in the blood to assess the severity of lactic acidosis, a sign of poor tissue oxygenation.

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Urine Output Monitoring in Sepsis

Constantly monitor the patient's urine output as a key indicator of kidney function and overall fluid balance.

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Sepsis

An excessive immune response to an infection, leading to a cascade of detrimental effects throughout the body.

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What is sepsis?

A condition where the body's immune system overreacts to an infection, leading to widespread inflammation and damage.

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Systemic Inflammatory Response Syndrome (SIRS)

The leakage of fluid from blood vessels into surrounding tissues due to increased permeability, caused by sepsis.

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Disseminated Intravascular Coagulation (DIC)

The formation of small blood clots throughout the body, restricting blood flow and oxygen delivery to tissues, a complication of sepsis.

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Anaerobic Respiration in Sepsis

The switch from using oxygen to produce energy to using glucose alone, leading to lactic acid buildup and metabolic acidosis, a consequence of reduced oxygen supply during sepsis.

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Systolic BP Drop

A reduction in systolic blood pressure of at least 40 mm Hg compared to a patient's usual baseline.

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Lactate Levels

The measurement of lactate levels in the blood to assess the severity of tissue oxygen deprivation during sepsis. Elevated lactate indicates that cells are switching to anaerobic respiration.

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Urine Output Target

The minimum urine output required to ensure proper kidney function and waste removal during sepsis. This is 0.5 mLs per kilogram of body weight per hour.

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Shock

A life-threatening condition where tissues and organs are not receiving enough oxygenated blood due to a failing circulatory system. This can be caused by problems with the heart, blood vessels, or fluid volume.

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How does sepsis affect heart function?

Sepsis causes a decrease in blood volume, leading to a drop in the heart's ability to pump blood efficiently, resulting in low blood pressure.

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What is Disseminated Intravascular Coagulation (DIC)?

This condition occurs when the body's blood clotting system goes into overdrive, forming clots in small blood vessels throughout the body. This blocks blood flow to organs, further reducing their oxygen supply.

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How does sepsis affect oxygen delivery?

Sepsis causes reduced blood flow to vital tissues and organs, leading to limited oxygen delivery and a shift to anaerobic metabolism.

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Why does sepsis cause metabolic acidosis?

Reduced blood flow to organs leads the body to switch to anaerobic metabolism, producing lactic acid as a byproduct. This excess lactic acid contributes to a state of metabolic acidosis.

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How does sepsis affect heart rate?

The hormone adrenaline is released during sepsis, causing blood vessels to widen and decrease blood volume, ultimately increasing the heart rate to try and compensate.

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What is the rapid A-E assessment used for?

This assessment helps evaluate a patient's condition quickly by assessing airway, breathing, circulation, disability, and exposure.

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What are the key aspects of sepsis treatment?

In sepsis, prompt treatment, including antibiotics, fluids, and supportive care, is crucial to improving the patient's chances of survival.

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What is Systemic Inflammatory Response Syndrome (SIRS)?

The leakage of fluid from blood vessels into surrounding tissues due to increased permeability, caused by sepsis.

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What is anaerobic respiration?

The switch from using oxygen to produce energy to using glucose alone, leading to lactic acid buildup and metabolic acidosis, a consequence of reduced oxygen supply during sepsis.

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What is shock?

A state of critically low blood pressure, often a consequence of sepsis, leading to inadequate organ perfusion and potential organ failure.

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Why give fluids in sepsis?

Giving fluids in sepsis aims to increase the volume of blood in the circulatory system, which helps deliver oxygen to cells.

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Why not give Hartmann's in sepsis?

Compound Sodium Lactate (Hartmann's) is avoided during sepsis because it contains lactate, which is already elevated due to the body's anaerobic metabolism.

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What is Noradrenaline used for in sepsis?

Noradrenaline is used in sepsis to constrict blood vessels, improving blood flow and oxygen delivery. Notropes, however, are not recommended.

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Why monitor urine output in sepsis?

Monitoring urine output in sepsis is essential for assessing kidney function, which may be impaired due to reduced blood flow.

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Sepsis management: How a patient benefits?

Sepsis is a serious condition that can lead to organ failure if not managed promptly. Prompt diagnosis and treatment are crucial for a positive outcome.

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Tachyapnea

A rapid breathing rate, often observed in sepsis or shock, as the body struggles to compensate for oxygen deficiency.

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Tachycardia

A rapid heart rate, a common symptom of sepsis or shock, due to the body trying to increase blood flow and oxygen delivery.

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Hypotension

Low blood pressure, a key sign of shock, indicating that the cardiovascular system is failing to deliver adequate blood flow.

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Study Notes

Clinical Management

  • Give Oxygen. Try to maintain SpO2 ≥94%.
  • Take blood cultures.
  • Give broad spectrum IV antibiotics.
  • Establish a fluid challenge (500 ml of Saline), over ≤15 min.
  • Measure the lactate, how much acidotic?
  • Monitor the urine output.

Antibiotic Crystalloids

  • Cefotaxime 500 ml of Saline

Role of the ODP

  • The role of the ODP is to recognise the sepsis, to perform an A-E assessment, to raise concerns, to support the anaesthetist, work appropriately within a multi-disciplinary team.

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Description

Test your knowledge on the clinical management of sepsis. This quiz covers key concepts such as immune response, fluid therapy, and the importance of monitoring vital signs and lab values in septic patients. Dive into the critical aspects needed for effective intervention in sepsis.

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