sepsis

Question 1

What is the pathophysiology of sepsis?

Answer 1

Sepsis usually begins with an infection (or presumed infection) that triggers the body’s immune response. The body releases chemicals that cause inflammation → blood vessel dilation → hypotension.

Question 2

What must happen before sepsis develops?

Answer 2

The patient must first meet SIRS criteria and have a presumed or identified infection.

Question 3

What is the sequence of sepsis progression?

Answer 3

SIRS (with presumed/identified infection) → Sepsis → MODS → Septic Shock.

Question 4

How are MODS and septic shock related?

Answer 4

They may be used interchangeably, depending on which criteria are met.

Question 5

What are common signs of infection that can lead to sepsis?

Answer 5

Fever, chills, gross-looking wound, UTI symptoms, pyelonephritis symptoms.

Question 6

What causes hypotension in sepsis?

Answer 6

Inflammatory mediators cause vasodilation and increased capillary permeability → decreased vascular resistance and hypotension.

Question 7

What are the clinical manifestations of sepsis?

Answer 7

• Meets SIRS criteria first + presumed/confirmed infection
• Fever or hypothermia
• Chills
• Tachycardia
• Tachypnea
• Hypotension
• Confusion or altered mental status
• Cool, clammy skin
• Weakness or fatigue

Question 8

What is the first diagnostic step for suspected sepsis?

Answer 8

Complete history and physical (H&P) and thorough assessment to find the infection source.

Question 9

What lab findings indicate sepsis?

Answer 9

• Leukocytosis – Elevated WBC
• Thrombocytopenia – Low platelets
• Elevated lactate ≥ 2.5 mmol/L (indicates poor perfusion)
• Elevated procalcitonin (infection marker)
• Abnormal PT/INR & PTT (DIC risk).

Question 10

What is DIC and how is it related to sepsis?

Answer 10

Disseminated Intravascular Coagulation – widespread microclotting and bleeding caused by severe sepsis and inflammation.

Question 11

What is the purpose of obtaining blood cultures in sepsis?

Answer 11

To identify the causative organism and guide antibiotic therapy.

Question 12

How many sets of blood cultures should be drawn and when?

Answer 12

2 sets before administering any antibiotics.

Question 13

What imaging studies help locate the source of infection in sepsis?

Answer 13

Chest X-ray, Ultrasound, CT scan — all based on H&P findings.

Question 14

What is the key to successful sepsis treatment?

Answer 14

Early recognition and rapid intervention.

Question 15

What is the Sepsis Bundle and when must it be completed?

Answer 15

A group of critical interventions (labs, blood cultures, fluids, antibiotics) that must be done within 3 hours of sepsis recognition.

Question 16

What are the main components of the Sepsis Bundle?

Answer 16

• Lab levels (including lactate)
• Blood cultures (before abx)
• Fluid resuscitation
• IV antibiotics.

Question 17

What are the main treatment goals in sepsis?

Answer 17

Control infection, restore blood flow, support failing organs (especially kidneys), and maintain perfusion and oxygenation.

Question 18

What type of fluids are used in sepsis treatment?

Answer 18

Normal Saline (NS) or Lactated Ringer’s (LR).

Question 19

What is the standard fluid bolus for sepsis patients?

Answer 19

30 mL/kg isotonic crystalloids for every patient, every time (unless contraindicated).

Question 20

Can you change the fluid resuscitation parameters independently?

Answer 20

No — only under physician’s orders.

Question 21

What does persistent hypotension after fluids indicate?

Answer 21

Septic shock. Start vasopressors (e.g., norepinephrine).

Question 22

When should antibiotics be given in sepsis?

Answer 22

Within 1 hour of diagnosis.

Question 23

Why is source control important in sepsis?

Answer 23

To eliminate the infection source — e.g., remove a contaminated Foley catheter in urosepsis.

Question 24

What are other treatment priorities for sepsis?

Answer 24

• Oxygen administration
• Blood glucose control (hyperglycemia common)
• Organ support (renal, respiratory).

Question 25

What are key nursing interventions for sepsis?

Answer 25

• Administer antibiotics within 1 hour • Monitor for fluid overload • Monitor VS and perfusion signs • Assess cap refill, urine output, and skin perfusion • Use sepsis screening tool • Monitor for organ dysfunction and MODS.

Question 26

What are signs of hypoperfusion in sepsis?

Answer 26

Delayed cap refill, decreased urine output, cool/clammy skin, persistent hypotension.

Question 27

What is MODS and how does it relate to sepsis?

Answer 27

Multiple Organ Dysfunction Syndrome: more than one organ is failing. Occurs when sepsis worsens and perfusion continues to decline.

Question 28

What nursing intervention helps maintain oxygenation?

Answer 28

Maintain O₂ saturation and elevate HOB.

Question 29

What complication should nurses monitor for in sepsis patients?

Answer 29

DIC – Disseminated Intravascular Coagulation.

Question 30

Why is BG control important in sepsis?

Answer 30

Hyperglycemia is common and worsens inflammation and infection outcomes.

Question 31

What is the nurse’s overall goal in managing sepsis?

Answer 31

Early detection, prompt treatment, maintain perfusion and oxygenation, prevent progression to MODS or septic shock.