SEPSIS_SEPTICEMIA - SEPSIS/SEPTICEMIA Sepsis is a syndrome characterized by clinical signs and symptoms of severe infection that may progress to

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SEPSIS/SEPTICEMIA Sepsis is a syndrome characterized by clinical signs and symptoms of severe infection that may progress to septicemia and septic shock. Septicemia implies the presence of an infection of the blood caused by rapidly multiplying microorganisms or their toxins, which can result in profound physiological changes and systemic sepsis. The pathogens can be bacteria, fungi, viruses, or rickettsiae. The most common causes of septicemia are Gram-negative bacteria (and endotoxins), staphylococci, and Candida. If the defense system of the body is not effective in controlling the invading microorganisms, septic shock may result, characterized by altered hemodynamics, impaired cellular function, and multiple system failure. Patients at highest risk for bacteremia and septic shock include the elderly, infants, and immunosuppressed patients with chronic diseases (e.g., diabetes); postoperative patients; and those with ventilators, invasive lines, and catheters. Early signs and symptoms may be vague, and sepsis can develop subtly until sudden, overwhelming septic shock is present, affecting multiple organ systems. CARE SETTING Although severely ill patients may require admission to an intensive care unit (ICU), this plan addresses care on an inpatient acute medical-surgical unit. RELATED CONCERNS AIDS Chronic obstructive pulmonary disease (COPD) and asthma Disaster considerations Fluid and electrolyte imbalances Metabolic acidosis (primary base bicarbonate deficiency) Peritonitis Pneumonia, microbial Psychosocial aspects of care Pulmonary tuberculosis (TB) Renal Failure: Acute Surgical Intervention Total nutritional support: parenteral/enteral feeding Ventilatory assistance (mechanical) Patient Assessment Database Data depend on the type, location, duration of the infective process and organ involvement. ACTIVITY/REST May report: Fatigue, malaise May exhibit: Mental status changes, e.g., withdrawn, lethargic Respiration/heart rate increased with activity CIRCULATION May exhibit: Blood pressure (BP) normal/slightly low-normal range (as long as cardiac output remains elevated); profound hypotension (late stage) Peripheral pulses bounding, rapid (hyperdynamic phase); weak/thready/easily obliterated, extreme tachycardia (shock) Heart sounds: Dysrhythmias and development of S 3 suggest myocardial dysfunction, effects of acidosis/electrolyte imbalance Skin warm, dry, flushed (vasodilation); or pale, cold, clammy, mottled (vasoconstriction) ELIMINATION May exhibit: Urinary output decreased, concentrated; progressing to oliguria, anuria Urine cloudy, malodorous
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FOOD/FLUID May report: Loss of appetite; nausea/vomiting May exhibit: Weight loss, decreased subcutaneous fat/muscle mass (malnutrition) Diminished/absent bowel sounds Extremity and generalized edema NEUROSENSORY May report: Headache; dizziness, fainting May exhibit: Restlessness, apprehension, confusion, disorientation, delirium/coma PAIN/DISCOMFORT May report:
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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SEPSIS_SEPTICEMIA - SEPSIS/SEPTICEMIA Sepsis is a syndrome characterized by clinical signs and symptoms of severe infection that may progress to

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