Sepsis and MODS Flashcards

A nurse should recognize that warm, flushed skin with bounding pulses in early septic shock reflects:

Answer: Vasodilation and high cardiac output (hyperdynamic phase)

Early 'warm shock' features vasodilation and a high-output hyperdynamic state.

Which hemodynamic profile is classic for septic shock?

Answer: Low SVR, high cardiac output, low CVP

Septic shock typically shows decreased SVR with high cardiac output and low filling pressures.

A target mean arterial pressure (MAP) of at least what value is recommended during septic shock resuscitation?

Answer: 65 mmHg

A MAP of at least 65 mmHg is the recommended initial perfusion target.

Which physiologic change explains why central venous oxygen saturation (ScvO2) may be elevated in late sepsis?

Answer: Impaired cellular oxygen extraction at the tissue level

Cytopathic injury prevents tissues from extracting oxygen, raising venous saturation.

A second vasopressor is often added to norepinephrine in refractory septic shock. Which agent is typically chosen?

Answer: Vasopressin

Vasopressin is commonly added to norepinephrine to raise MAP and reduce catecholamine dose.

When myocardial dysfunction causes low cardiac output despite adequate volume and MAP in sepsis, which inotrope is recommended?

Answer: Dobutamine

Dobutamine is added to improve contractility when sepsis-induced cardiomyopathy lowers output.

Passive leg raise is used in septic resuscitation primarily to assess:

Answer: Fluid responsiveness before giving more volume

A passive leg raise provides a reversible autotransfusion to predict fluid responsiveness.