Perrin: Understanding the Essentials of Critical Care Nursing Chapter 17: Care of the Patient with Sepsis MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the questions 1) Which of the following statements is true about sepsis? A) Mortality rates from sepsis approached 70% worldwide in 2001. B) If managed early and aggressively, the majority of patients with sepsis may be managed outside of the ICU environment. C) The guidelines provided by the Surviving Sepsis Campaign (2004) are expected to decrease the incidence of sepsis by the year 2010. D) Sepsis rates rise sharply with age. Answer: D Explanation: A) Sepsis rates rise sharply with age. #1 is incorrect. Overall mortality rates are 28% to 29 up to 38% in older individuals in the United States. #2 is incorrect because seventy percent of patients with sepsis are managed in the ICU. #3 is incorrect. Sepsis rates continue to increase due to aging of the general population, though more people are expected to survive sepsis. Nursing Process: Physiological Integrity: Physiological Adaptation Cognitive Level: Knowledge Category of Need: Physiological Integrity, Reduction of Risk Potential B) Sepsis rates rise sharply with age. #1 is incorrect. Overall mortality rates are 28% to 29 up to 38% in older individuals in the United States. #2 is incorrect because seventy percent of patients with sepsis are managed in the ICU. #3 is incorrect. Sepsis rates continue to increase due to aging of the general population, though more people are expected to survive sepsis. Nursing Process: Physiological Integrity: Physiological Adaptation Cognitive Level: Knowledge Category of Need: Physiological Integrity, Reduction of Risk Potential C) Sepsis rates rise sharply with age. #1 is incorrect. Overall mortality rates are 28% to 29 up to 38% in older individuals in the United States. #2 is incorrect because seventy percent of patients with sepsis are managed in the ICU. #3 is incorrect. Sepsis rates continue to increase due to aging of the general population, though more people are expected to survive sepsis. Nursing Process: Physiological Integrity: Physiological Adaptation Cognitive Level: Knowledge Category of Need: Physiological Integrity, Reduction of Risk Potential D) Sepsis rates rise sharply with age. #1 is incorrect. Overall mortality rates are 28% to 29 up to 38% in older individuals in the United States. #2 is incorrect because seventy percent of patients with sepsis are managed in the ICU. #3 is incorrect. Sepsis rates continue to increase due to aging of the general population, though more people are expected to survive sepsis. Nursing Process: Physiological Integrity: Physiological Adaptation Cognitive Level: Knowledge Category of Need: Physiological Integrity, Reduction of Risk Potential 2) Two of the most common sources of infection that lead to sepsis in a patient over the age of 65 include: A) Pneumonia and urinary tract infections. B) Skin infections and diabetes. C) Surgical incisions and abdominal wounds. D) Traumatic wounds and abdominal surgeries. Answer: A Explanation: A) The most common source of sepsis stems from urinary tract infections and pneumonia. Among older patients, the most common source of infection is the urinary tract. The second most common source, the lungs, accounts for 35% of sepsis cases. #2 is incorrec Skin and soft tissue account only for 7% of sepsis. Other sources only account for 8% which makes #3 and #4 incorrect. Nursing Process: Assessment Cognitive Level: Knowledge Category of Need: Physiological Integrity: Physiological Adaptation B) The most common source of sepsis stems from urinary tract infections and pneumonia. Among older patients, the most common source of infection is the urinary tract. The second most common source, the lungs, accounts for 35% of sepsis cases. #2 is incorrec Skin and soft tissue account only for 7% of sepsis. Other sources only account for 8% which makes #3 and #4 incorrect. Nursing Process: Assessment Cognitive Level: Knowledge Category of Need: Physiological Integrity: Physiological Adaptation C) The most common source of sepsis stems from urinary tract infections and pneumonia. Among older patients, the most common source of infection is the urinary tract. The second most common source, the lungs, accounts for 35% of sepsis cases. #2 is incorrec Skin and soft tissue account only for 7% of sepsis. Other sources only account for 8% which makes #3 and #4 incorrect. Nursing Process: Assessment Cognitive Level: Knowledge Category of Need: Physiological Integrity: Physiological Adaptation D) The most common source of sepsis stems from urinary tract infections and pneumonia. Among older patients, the most common source of infection is the urinary tract. The second most common source, the lungs, accounts for 35% of sepsis cases. #2 is incorrec Skin and soft tissue account only for 7% of sepsis. Other sources only account for 8% which makes #3 and #4 incorrect. Nursing Process: Assessment Cognitive Level: Knowledge Category of Need: Physiological Integrity: Physiological Adaptation 3) Which evidence- based intervention would the nurse use to prevent pneumonia in the patient receiving mechanical ventilation? A) Aseptic technique when performing oral hygiene B) Administration of an H2 antagonist to prevent peptic ulcers C) Elevation of the head of the bed to 15 degrees to prevent aspiration D) Changing the ventilator circuit daily Answer: B Explanation: A) One of the evidenc-ebased practices used to prevent ventila- taosrsociated pneumonia includes the use of an 2Hantagonist to prevent peptic ulcers. Preventing pneumonia leads to decreased rates of sepsis. #3 and #4 are incorrect. The head of the bed should elevated at least 30 degrees, and the ventilator circuit is changed weekly. Oral hygiene is a clean, rather than a sterile, procedure, thus #1 is incorrect. Nursing Process: Intervention Cognitive Level: Application Category of Need: Physiological Integrity: Reduction in Risk Potential B) One of the evidenc-ebased practices used to prevent ventila- taosrsociated pneumonia includes the use of an 2Hantagonist to prevent peptic ulcers. Preventing pneumonia leads to decreased rates of sepsis. #3 and #4 are incorrect. The head of the bed should elevated at least 30 degrees, and the ventilator circuit is changed weekly. Oral hygiene is a clean, rather than a sterile, procedure, thus #1 is incorrect. Nursing Process: Intervention Cognitive Level: Application Category of Need: Physiological Integrity: Reduction in Risk Potential C) One of the evidenc-ebased practices used to prevent ventila- taosrsociated pneumonia includes the use of an 2Hantagonist to prevent peptic ulcers. Preventing pneumonia leads to decreased rates of sepsis. #3 and #4 are incorrect. The head of the bed should elevated at least 30 degrees, and the ventilator circuit is changed weekly. Oral hygiene is a clean, rather than a sterile, procedure, thus #1 is incorrect. Nursing Process: Intervention Cognitive Level: Application Category of Need: Physiological Integrity: Reduction in Risk Potential D) One of the evidenc-ebased practices used to prevent ventila- taosrsociated pneumonia includes the use of an 2Hantagonist to prevent peptic ulcers. Preventing pneumonia leads to decreased rates of sepsis. #3 and #4 are incorrect. The head of the bed should elevated at least 30 degrees, and the ventilator circuit is changed weekly. Oral hygiene is a clean, rather than a sterile, procedure, thus #1 is incorrect. Nursing Process: Intervention Cognitive Level: Application Category of Need: Physiological Integrity: Reduction in Risk Potential