Sepsis and Septic Shock Management Flashcards
7 cards from real Acute Care Nurse Practitioner practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Sepsis and Septic Shock Management flashcards as text
According to the Sepsis-3 consensus definition (2016), sepsis is best defined as:
Answer: Life-threatening organ dysfunction caused by a dysregulated host response to infection
Sepsis-3 (2016) redefined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, replacing the older SIRS-based criteria.
An acute increase in the total Sequential Organ Failure Assessment (SOFA) score of ≥ ___ points indicates organ dysfunction consistent with sepsis:
Answer: 2
An acute change in total SOFA score ≥2 points above baseline indicates organ dysfunction in the setting of suspected infection, meeting the Sepsis-3 definition of sepsis.
According to Sepsis-3 criteria, septic shock is distinguished from sepsis by the requirement for which combination of findings?
Answer: Vasopressor requirement to maintain MAP ≥ 65 mmHg AND serum lactate > 2 mmol/L despite adequate volume resuscitation
Septic shock requires both vasopressor dependence to maintain MAP ≥65 mmHg and serum lactate >2 mmol/L despite adequate resuscitation, indicating profound circulatory and cellular metabolic abnormalities.
The quick SOFA (qSOFA) score is a bedside screening tool for sepsis risk. Which three parameters comprise the qSOFA score?
Answer: Altered mental status, respiratory rate ≥ 22 breaths/min, systolic BP ≤ 100 mmHg
qSOFA uses three bedside variables: altered mentation, RR ≥22/min, and SBP ≤100 mmHg; a score ≥2 identifies patients at high risk for poor outcomes outside the ICU.
In a patient with suspected sepsis, when should blood cultures optimally be collected relative to antibiotic administration?
Answer: Before antibiotic administration, with at least 2 sets drawn from separate venipuncture sites
At least 2 sets of blood cultures from separate venipuncture sites should be obtained before initiating antibiotics to maximize pathogen identification while reducing contamination false positives.
According to the Surviving Sepsis Campaign (SSC) Hour-1 Bundle, which actions must be completed within the first hour of recognizing sepsis or septic shock?
Answer: Measure lactate, obtain blood cultures before antibiotics, administer broad-spectrum antibiotics, and give 30 mL/kg crystalloid if hypotensive
The SSC Hour-1 Bundle requires measuring lactate, obtaining blood cultures before antibiotics, administering broad-spectrum antibiotics, and beginning fluid resuscitation in hypotensive or hyperlactatemic patients.
Elevated serum lactate in sepsis most primarily reflects:
Answer: Anaerobic metabolism from tissue hypoperfusion and mitochondrial dysfunction
Hyperlactatemia in sepsis is primarily driven by tissue hypoperfusion leading to anaerobic glycolysis, though mitochondrial dysfunction and impaired hepatic clearance contribute as well.