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1.5 CE Test Hours

A Review of the Revised Sepsis Care Bundles

Contrada, Emily

AJN The American Journal of Nursing: August 2018 - Volume 118 - Issue 8 - p 50,51
doi: 10.1097/01.NAJ.0000544140.01629.4f
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Figure.

Figure.

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A Review of the Revised Sepsis Care Bundles

GENERAL PURPOSE:

To provide information about recent revisions to the sepsis care bundles.

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LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing education activity, you should be able to

  • outline the latest revisions to the sepsis care bundles.
  • discuss the use of sepsis assessment and screening tools for patients in various acute care settings.
  1. Each year in the United States, sepsis kills about how many people?
    1. 250,000
    2. 475,000
    3. 640,000
  2. Compared with standard care, early goal-directed therapy for sepsis has reduced mortality by what percentage?
    1. nearly 5%
    2. about 10%
    3. more than 15%
  3. Earlier criteria defined severe sepsis as sepsis in the presence of multiple organ dysfunction syndrome, hypoperfusion, or
    1. acidosis.
    2. hypotension.
    3. pyrexia.
  4. By current criteria, patients who require vasopressor therapy to maintain a mean arterial pressure (MAP) of at least 65 mmHg, or have a serum lactate level > 2 mmol/L, despite adequate fluid resuscitation, have
    1. septic shock.
    2. multiple organ dysfunction syndrome.
    3. systemic inflammatory response syndrome (SIRS).
  5. In contrast to the Sequential Organ Failure Assessment (SOFA) score, the quick SOFA (qSOFA)
    1. requires multiple laboratory tests.
    2. can be repeated frequently.
    3. evaluates platelets.
  6. Outside of the ICU, which of the following assessment methods has significantly greater predictive validity for in-hospital mortality?
    1. SOFA
    2. SIRS criteria
    3. qSOFA
  7. In combination with protocol-driven staff response, the implementation of electronic screening tools has reduced door-to-antibiotics times by how many minutes?
    1. 31
    2. 59
    3. 72
  8. Lactate levels of ≥ 4 mmol/L are associated with a mortality rate of
    1. 10%.
    2. 20%.
    3. 30%.
  9. As part of the 1-hour bundle, 2 or more blood cultures should be collected before broad-spectrum antibiotics are administered, provided it does not delay antibiotic administration by more than how many minutes?
    1. 45
    2. 60
    3. 75
  10. The 1-hour sepsis bundle recommends administering a 30 mL/kg bolus of crystalloid IV fluids to treat
    1. hypoxemia.
    2. dehydration.
    3. hypotension.
  11. Following Surviving Sepsis Campaign (SSC) resuscitation recommendations may result in volume overload, especially in patients with
    1. acute respiratory distress syndrome.
    2. coronary artery disease.
    3. diabetes mellitus.
  12. In one study of adult ICU patients receiving treatment for sepsis or septic shock, 48% had persistent fluid overload into day
    1. 3.
    2. 4.
    3. 5.
  13. The first-line vasopressor for septic shock is
    1. dopamine.
    2. vasopressin.
    3. norepinephrine.
  14. Which of the following medications is not recommended for treating septic shock unless other medications have been ineffective?
    1. norepinephrine
    2. phenylephrine
    3. vasopressin
  15. A serum lactate level > 2 mmol/L, despite adequate volume resuscitation and recommended maintenance of MAP, is associated with a hospital mortality rate
    1. of nearly 30%.
    2. of about 35%.
    3. above 40%.
  16. For hospitals ranking in the lowest quartile for preventable hospital-acquired infections, including sepsis, the Centers for Medicare and Medicaid Services assesses a payment reduction of
    1. 1%.
    2. 2%.
    3. 3%.
  17. When used appropriately in hospitals, which of the following has been shown to reduce the number of code blues by as much as 50%?
    1. SIRS criteria
    2. Modified Early Warning Score
    3. SOFA
  18. In treating adults with sepsis-induced acute respiratory distress syndrome who require mechanical ventilation, best practices include the use of
    1. noninvasive ventilation.
    2. higher positive end-expiratory pressure (PEEP) over lower PEEP.
    3. high-frequency oscillatory ventilation.
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