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