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Nursing:
doi: 10.1097/01.NURSE.0000445925.42308.5e
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Surviving sepsis: A review of the latest guidelines

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INSTRUCTIONS Surviving sepsis: A review of the latest guidelines

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Surviving sepsis: A review of the latest guidelines

GENERAL PURPOSE: To provide information about the latest surviving sepsis guidelines (SSG). LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to: 1. Identify the signs of sepsis. 2. Recognize goal-directed therapies recommended by the SSG.

  1. When sepsis is identified, chances of death are approximately
    1. 1 in 2.
    2. 1 in 4.
    3. 1 in 10.
    4. 1 in 20.
  2. Patients with severe sepsis typically have a
    1. low diastolic pressure.
    2. elevated systolic pressure.
    3. low MAP.
    4. high MAP.
  3. The definition of sepsis-induced tissue hypoperfusion includes
    1. oliguria.
    2. hypertension.
    3. low lactate level.
    4. decreased C-reactive protein level.
  4. Septic shock is fluid-refractory sepsis-induced
    1. polyuria.
    2. bradycardia.
    3. hypotension.
    4. hyperthermia.
  5. If severe sepsis is suspected, antibiotics should be administered within
    1. 1 hour.
    2. 2 hours.
    3. 4 hours.
    4. 8 hours.
  6. Isotonic crystalloid fluid resuscitation should be initiated when the patient's lactate level is
    1. 1 mmol/L.
    2. 2 mmol/L.
    3. 3 mmol/L.
    4. 4 mmol/L.
  7. The widening pulse pressure seen in patients with sepsis is caused by
    1. vasodilation.
    2. vasoconstriction.
    3. acute kidney injury.
    4. autonomic dysfunction.
  8. Dehydration and impaired oxygen delivery to the tissues promotes
    1. alveolar hemorrhage.
    2. polyuria.
    3. hypertension.
    4. intravascular thrombosis.
  9. To restore circulating blood volume, early goal-directed therapy includes fluid resuscitation at a rate of
    1. 30 mL/kg.
    2. 50 mL/kg.
    3. 80 mL/kg.
    4. 100 mL/kg.
  10. After fluid resuscitation, I.vasopressors should be instituted if the MAP fails to reach at least
    1. 50 mm Hg.
    2. 55 mm Hg.
    3. 60 mm Hg.
    4. 65 mm Hg.
  11. To help restore circulating volume when giving substantial amounts of crystalloids, add I.V.
    1. glucose.
    2. albumin.
    3. sodium bicarbonate.
    4. hydroxyethyl starches.
  12. If fluid therapy fails to restore an adequate BP, the first-line vasopressor is
    1. dopamine.
    2. epinephrine.
    3. dobutamine.
    4. norepinephrine.
  13. ScvO2 is measured using blood obtained from the patient's
    1. femoral artery.
    2. radial artery.
    3. CVC distal port.
    4. antecubital vein.
  14. To reduce mortality from severe sepsis, the SSG recommend starting goal-directed therapy within the first
    1. 6 hours.
    2. 8 hours.
    3. 12 hours.
    4. 24 hours.
  15. To determine when to discontinue antibiotics, the healthcare provider can use
    1. procalcitonin levels.
    2. immunoglobulin levels.
    3. white blood cell counts.
    4. blood cultures.
  16. If the patient fails to achieve hemodynamic stability with I.fluids and vasopressors, the healthcare provider may add daily I.V.
    1. blood products.
    2. hydrocortisone.
    3. diphenhydramine.
    4. immunoglobulin.
  17. When patients with sepsis require mechanical ventilation, the SSG recommend using
    1. platelets.
    2. packed red blood cells.
    3. the least amount of sedation.
    4. neuromuscular blocker agents.
  18. After recognizing severe sepsis, the clinician should initiate oral or enteral nutrition support within
    1. 48 hours.
    2. 72 hours.
    3. 96 hours.
    4. 5 days.
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