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
What is the recommended initial fluid resuscitation volume for sepsis-induced tissue hypoperfusion according to Surviving Sepsis Campaign guidelines?
Answer: 30 mL/kg of isotonic crystalloid administered within 3 hours
The SSC guidelines recommend at least 30 mL/kg of isotonic crystalloid (normal saline or lactated Ringer's) within 3 hours for sepsis-induced hypoperfusion or hypotension.
Which vasopressor is recommended as first-line therapy for septic shock to maintain mean arterial pressure ≥ 65 mmHg?
Answer: Norepinephrine at 0.01-3 mcg/kg/min
Norepinephrine is the first-line vasopressor for septic shock due to its potent alpha-1 adrenergic vasoconstriction with modest beta-1 effects, reliably raising MAP with less tachycardia than dopamine.
Which empiric antibiotic regimen is most appropriate for a patient with community-acquired septic shock of unknown source?
Answer: Vancomycin plus piperacillin-tazobactam or meropenem, with atypical coverage if pneumonia is suspected
Empiric therapy for septic shock requires broad-spectrum coverage including MRSA (vancomycin) and gram-negative organisms (pip-tazo or carbapenem) until cultures guide de-escalation.
A patient in septic shock remains hypotensive on norepinephrine 0.25 mcg/kg/min with MAP of 58 mmHg. What is the most appropriate next step for vasopressor management?
Answer: Add vasopressin 0.03-0.04 units/min as a norepinephrine-sparing adjunct to raise MAP
Vasopressin at 0.03-0.04 units/min is recommended as an adjunct to norepinephrine in refractory septic shock, acting on V1 receptors independently of catecholamine pathways to reduce norepinephrine requirements.
Under which clinical circumstances should intravenous hydrocortisone be administered in septic shock?
Answer: When septic shock remains refractory to adequate fluid resuscitation and vasopressor therapy
Hydrocortisone 200 mg/day IV is recommended for septic shock not adequately stabilized with fluid resuscitation and vasopressors, not as routine first-line therapy for all sepsis patients.
According to current Surviving Sepsis Campaign guidelines, packed red blood cells should be transfused in septic shock when hemoglobin falls below:
Answer: 7 g/dL in adults without active myocardial ischemia, severe hypoxemia, or acute hemorrhage
SSC recommends a restrictive transfusion strategy with a threshold of 7 g/dL for most adult patients with sepsis, reserving higher thresholds for those with myocardial ischemia or active hemorrhage.
What is the recommended blood glucose target for patients in septic shock receiving insulin therapy?
Answer: Blood glucose ≤ 180 mg/dL using a validated protocol with frequent glucose monitoring
SSC recommends insulin therapy targeting glucose ≤180 mg/dL; the NICE-SUGAR trial demonstrated that tight control targeting 80-110 mg/dL increased mortality compared with the conventional target.