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Saturday, November 23, 2013

Sepsis

Sepsis & MODS CCRN Review Hildy Schell,RN,MS,CCRN,CCNS CNS, Adult Critical Care UCSF Medical center Objectives By the finish of class, the participant will be up to(p) to: 1. Identify the pathophysiologic mechanisms of sepsis that asterisk to MODS. 2. List the clinical bribeation of a patient with horrendous sepsis & MODS. 3. List nursing priorities for monitoring & worry of the patient with weighty sepsis. 4. List the goals of therapy and priority interventions for repellent sepsis & infectious shock. Definitions Colonization befoulment Infection Bacteremia/Fungemia/Viremia SIRS: Sepsis implike Sepsis infectious break MODS: multiple organ disfunction syndrome general inflammatory reply syndrome Sepsis ? Sepsis: systemic inflammatory response to an infection. ? Characterized by 2 or more of following: T > 38º or < 36º C HR > 90 RR > 20 or PaCO2 < 32 WBC > 12k, < 4k, or > 10% bands.
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intense Sepsis ?Severe Sepsis: Sepsis with manifestations of organ dysfunction AMS Hypoxemia Oliguria ? lactate levels 1 Septic Shock ?Septic Shock: Severe sepsis plus hypotension/ comparative hypotension ?SBP < 90 or ?40 mmHg from baseline SIRS Pancreatitis Infection SEPSIS harm Burns Other affinity of Sepsis and SIRS Sepsis ? ? ? ? ? Emergency Department (1000) ? 49 A major cause of morbidness & mortality planetary Leading cause of destruction in Non-?intensive care units in U.S. ICU mortality is 4 x greater if severe sepsis is present 10th leading cause of death in U.S. Estimated that it be over 17 billion $$$ annually to c are for patients with severe sepsis y.o. ! female, teacher, mother, wife cough, hemoptysis, SOB ? PMHx: negative ? Cool, clammy, diaphoretic ? Thready pulses, crackles/rhonci ? Awake, ordered ? HR 130, BP 80/45, T 36.4, RR 24 ? Sp02 92% on 4LPM via NC ? c/o Risk Factors Age Malnutrition continuing affection: DM, ESRD, ESLD, CA, HIV Medications Medical/Surgical interventions Pheresis Splenectomy ...If you requisite to check a full essay, order it on our website: OrderCustomPaper.com

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