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1.5 CE Test Hours

Managing Sepsis and Septic Shock

Current Guidelines and Definitions

Contrada, Emily

AJN The American Journal of Nursing: February 2018 - Volume 118 - Issue 2 - p 40,41
doi: 10.1097/01.NAJ.0000530243.07593.e7
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Managing Sepsis and Septic Shock: Current Guidelines and Definitions

GENERAL PURPOSE:

To provide information about the new Surviving Sepsis Campaign treatment guidelines and the Third International Consensus Definitions for Sepsis and Septic Shock definitions and tools.

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LEARNING OBJECTIVES/OUTCOMES:

After completing this educational activity, you should be able to

  • outline the new treatment guidelines and changes in the sepsis bundle interventions.
  • discuss how the new tools can be used to predict adverse outcomes in patients with infection.
  1. Sepsis accounts for what proportion of all deaths in U.S. hospitals?
    1. nearly one-tenth
    2. about one-quarter
    3. more than one-third
  2. Back in 1991, systemic inflammatory response syndrome was said to be characterized by more than one of several clinical symptoms, including
    1. abnormally high or low temperature.
    2. decreased sedimentation rate.
    3. decreased respiratory rate.
  3. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) focus on sepsis as a multifaceted response to infection that results in
    1. platelet aggregation.
    2. organ dysfunction.
    3. immune deficiency.
  4. The new Sepsis-3 definitions no longer focus on which of the following in the presence of infection?
    1. inflammation
    2. hypertension
    3. hypoxia
  5. Septic shock is now defined as a subset of sepsis in which the patient has profound
    1. delirium.
    2. dehydration.
    3. hypoperfusion.
  6. The Sequential Organ Failure Assessment (SOFA) evaluates 6 physiologic functions, one of which is
    1. hepatic.
    2. immune.
    3. pancreatic.
  7. To calculate a patient's SOFA score, it is necessary to obtain which of the following laboratory values?
    1. potassium
    2. bilirubin
    3. myoglobin
  8. The quick SOFA (qSOFA) relies on 3 variables: mentation, systolic blood pressure, and
    1. temperature.
    2. respiratory rate.
    3. oxygen saturation.
  9. In non-ICU patients, the qSOFA score
    1. predicts an elevated risk of death.
    2. provides an early warning of sepsis.
    3. identifies the need for transfer to the ICU.
  10. A serum lactate level greater than 2 mmol/L suggests
    1. kidney injury.
    2. myocardial infarction.
    3. hypoperfusion.
  11. The Surviving Sepsis Campaign (SSC) guidelines recommend fluid resuscitation with at least what amount of fluid within 3 hours of sepsis-induced hypoperfusion?
    1. 15 mL/kg
    2. 30 mL/kg
    3. 45 mL/kg
  12. The SSC guidelines recommend administration of IV antibiotics within how many minutes of suspected sepsis or septic shock?
    1. 15
    2. 30
    3. 60
  13. In the study used to develop the new Sepsis-3 definitions, what percentage of the patients with a suspected infection who scored 2 or higher on the qSOFA also had a positive SOFA score?
    1. nearly 45%
    2. about 60%
    3. more than 75%
  14. An abnormal physiologic parameter of the SOFA scoring system is platelets below
    1. 100 x 103/mm3.
    2. 200 x 103/mm3.
    3. 300 x 103/mm3.
  15. Which of the following bilirubin values is significant for SOFA scoring?
    1. 1 mg/dL
    2. 2 mg/dL
    3. 3 mg/dL
  16. Which of the following Glasgow Coma Scale scores is significant for SOFA scoring?
    1. 11
    2. 13
    3. 15
  17. Which of the following values is significant for SOFA scoring?
    1. urine output of 550 mL/day
    2. urine output of 600 mL/day
    3. creatinine of 2 mg/dL or higher
  18. Which of the following is significant for qSOFA scoring?
    1. any change in mental status
    2. respiratory rate of 20 bpm
    3. systolic blood pressure over 100 mmHg
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