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NURS 6501 Wk Assignment-Sepsis

NURS 6501 Wk Assignment-Sepsis

NURS 6501 Wk Assignment-Sepsis Objectives

  • Explain the pathophysiology of sepsis
  • Examine changes to the respiratory and neurological systems due to alterations caused by sepsis
  • List patients factors such as gender, age, behavior, genetics, and ethnicity and its impact on the disorder of sepsis
  • Discuss the diagnosis and treatment of septic patients

What IS SEPSIS?

  • Leading cause of death in the United States
  • Body’s response to an untreated infection
  • Different stages of sepsis
  • Systemic inflammatory response syndrome (SIRS)
  • Temperature >38 C or <36 C
  • Heart rate >90/min
  • Respiratory rate .20/min
  • WBC >12 x 109/L or <4 x 109/L
  • Sepsis – SIRS with an infection
  • Severe Sepsis
  • Septic shock
  • Is a inflammatory state (SIRS) caused by an infectious agent
  • Main areas infections in sepsis are seen – respiratory tract, genitourinary tract, gastrointestinal tract, device-related infections, wound or soft tissue infections

NURS 6501 Wk Assignment-Sepsis

Signs and symptoms

  • Confusion/disorientation/agitation
  • Shortness of breath
  • Tachycardia
  • Fever or shivering
  • Pain or discomfort
  • Clammy/sweaty
  • Low blood pressure
  • Decreased urination

Pathophysiology

  • Starts with a localized infections that eventually gets in the bloodstream directly or the bacteria can release toxins into the blood stream
  • Bacterial agents include Enterobacteriaceae, Pseudomonas, and Staphylococci. Fungal causative agents include P aeruginosa and Candida.
  • The host inflammatory response is heightened and multiple numbers of inflammatory mediators are released
  • Endotoxins activate macrophages that cause inflammatory response within the body. The response affects the host in multiple ways such as fever, tachycardia, platelet adherence, vasodilation. These factors lead to cellular hypoxia, toxic oxygen radicals, and low systemic vascular resistance
  • Eventually the host has lactic acidosis and can also have multi-organ dysfunction that will lead to death (Hammer & McPhee, 2014)

Respiratory

  • Sepsis causes acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) – second most common cause (Iskander, 2013)
  • The endothelial injury to the pulmonary vasculature leads to increased microvascular permeability. Interstitial and alveolar pulmonary edema occurs as a result. Pulmonary edema causes ventilation-perfusion mismatch which eventually leads to hypoxemia (Neviere, 2016).
  • Neutrophil accumulation and degranulation in the capillaries of the lungs leads to increased vascular permeability and injury. This results in diffuse alveolar damage. The increased permeability allows for fibrin-rich edema fluid, red blood cells, and neutrophils to get into the alveoli (Iskander, 2013)
  • Bacteria and inflammatory cytokines in septic patients, initiate the release of neutrophils (Iskander, 2013)
  • Respiratory complications either resolve through regeneration or have interstitial fibrosis which can cause long-term problems (Iskander, 2013

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NURS 6501 Wk Assignment-Sepsis References

  • Balentine, J.R. (2017). Sepsis (Blood infection). eMedicineHealth. Retrieved on October 25, 2017 from, https://www.emedicinehealth.com/sepsis_blood_infection/article_em.htm?pf=2
  • Center for Disease Control and Prevention. (2017). Sepsis. Retrieved on October 25, 2017 from https://www.cdc.gov/sepsis/basic/index.html
  • Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
  • Iskander, K.N., Osuchowski, M.F., Steams-Kurosawa, D.J., Kurosawa, S., Valentine, C., & Remick, D.G. (2013). Sepsis: Multiple abnormalities, heterogeneous responses, and evolving understanding. Physiol Rev 93(3): 1247-1288. doi:10.1152/physrev.00037.2012
  • Mayo Clinic. (2017). Sepsis. Retrieved on October 25, 2017 from, https://www.mayoclinic.org/diseases-conditions/sepsis/diagnoiss-treatment
  • Nasir, N., Jamil, B., Siddiqui, S., Talat, N., Khan, F.A., & Hussain, R. (2013). Mortality in sepsis and its relationship with gender. Pak J Med Sci, 31(5): 1201-1206. doi:http://dx.doi.org/10.12669/pjms.315.6925
  • Neviere, R. (2016). Pathophysiology of Sepsis. UptoDate. Retrieved on October 27, 2017 from https://www.uptodate.com/contents/pathophysiology-of-sepsis/