Critical care

Septic shock causes system wide vasodilation which leads to an increase in systemic vascular resistance. In addition, septic shock causes increased capillary permeability and clot formation in the microcirculation throughout the body.

2. A patient is diagnosed with septic shock. As the nurse you know this is a __________ form of shock. In addition, you’re aware that __________ and _________ are also this form of shock.

3. Your patient, who is post-op from a gastrointestinal surgery, is presenting with a temperature of 103.6 ‘F, heart rate 120, blood pressure 72/42, increased white blood cell count, and respirations of 21. An IV fluid bolus is ordered STAT. Which findings below indicate that the patient is progressing to septic shock? Select all that apply:

4. You’re providing care to four patients. Select all the patients who are at risk for developing sepsis:

5. A patient with a severe infection has developed septic shock. The patient’s blood pressure is 72/44, heart rate 130, respiration 22, oxygen saturation 96% on high-flow oxygen, and temperature 103.6 ‘F. The patient’s mean arterial pressure (MAP) is 53 mmHg. Based on these findings, you know this patient is experiencing diminished tissue perfusion and needs treatment to improve tissue perfusion to prevent organ dysfunction. In regards to the pathophysiology of septic shock, what is occurring in the body that is leading to this decrease in tissue perfusion? Select all that apply:

6. A patient with a fever is lethargic and has a blood pressure of 89/56. The patient’s white blood cell count is elevated. The physician suspects the patient is developing septic shock. What other findings indicate this patient is in the “early” or “compensated” stage of septic shock? Select all that apply:

7. Your patient is receiving aggressive treatment for septic shock. Which findings demonstrate treatment is NOT being successful? Select all that apply:

8. The physician orders a patient in septic shock to receive a large IV fluid bolus. How would the nurse know if this treatment was successful for this patient?

9. A patient in septic shock receives large amounts of IV fluids. However, this was unsuccessful in maintaining tissue perfusion. As the nurse, you would anticipate the physician to order what NEXT?

10. A patient is on IV Norepinephrine for treatment of septic shock. Which statement is FALSE about this medication?

11. Your patient’s blood pressure is 72/56, heart rate 126, and respiration 24. The patient has a fungal infection in the lungs. The patient also has a fever, warm/flushed skin, and is restless. You notify the physician who suspects septic shock. You anticipate that the physician will order what treatment FIRST?