In the ICU, a patient has been diagnosed with sepsis due to a ...

[ssal]

In the ICU, a patient has been diagnosed with sepsis due to a bacterial invasion.
 
  The human body usually responds to infections by developing an uncontrolled inflammatory response with large production and release of inflammatory cytokines such as IL-1 and TNF-a. The nurse will note which of the following clinical manifestations in this septic patient as a result of the activation of these cytokines? Select all that apply.
  A)
  Excessive interstitial edema related to increased vascular permeability
  B)
  Decreased cardiac output resulting from myocardial depression
  C)
  Increased respiratory rate with crackles heard throughout all lung fields
  D)
  Excessive bleeding from bowels and bladder
  E)
  Lower blood pressure due to intravascular fluid loss

Question 2

A male elementary school student has a severe allergy to peanuts and is displaying the signs of anaphylactic shock after inadvertently eating a peanut-containing candy bar.
 
  Which of the following statements best captures the boy's current status and preferred treatment?
  A)
  He is experiencing shortness of breath caused by potent vasoconstriction that can be relieved by epinephrine injection.
  B)
  He is approaching vascular shock and developing edema due to actions of IgE antibodies, situations that can be reversed by administration of epinephrine.
  C)
  His mast cells and basophils have been sensitized, but systemic effects can be mitigated by administration of bronchodilators.
  D)
  He is likely in a primary- or initial-stage allergic response that can be relieved by antihistamine administration.

[ally]

Answer to Question 1

Ans:
A, B, E

Feedback:

SIRS (systemic inflammatory response syndrome) can develop as a result of large quantities of microbes entering the blood, resulting in the release of enormous quantities of inflammatory cytokines. They cause generalized vasodilation (hypotension), increased vascular permeability (fluid loss into the tissues), intravascular fluid loss (dehydration with low urine output and low BP), myocardial depression (decreased cardiac output), and circulatory shock.

Answer to Question 2

Ans:
B

Feedback:

Anaphylactic reactions are often accompanied by vascular shock and edema, and the normal treatment is epinephrine injection. Symptoms are caused by vasodilation, not vasoconstriction; bronchodilators are not the ideal treatment.

[ssal]

Gracias!

[bdobbins]

TYSM