Micro test 2

Not typical, really relates to the cell wall

Proteins, oxygen free radicals, and lipids

• Tumor Necrosis Factor
• Interleukin-1
• Interleukin-6
• Interleukin-8

• Oxygen (O2-)
• Hydrogen Peroxide (H2O2)
• Nitric Oxide (NO)

• Prostaglandin E2
• Thromboxane A2
• Platerlet-activation factor

• Low = Beneficial effects
• Moderate fever
• Generalized stimulation of immune system
• Microbial killing

• High = Harmful effects
• High fever
• Hypotension
• Disseminated blood clotting
• Lethal shock

Was used back in the day for treatment of cancer

• Nitric oxide
• Single Oxygen Perhydroxyl
• Peroxide

Low blood pressure

Can bust causing water to leak out which then can cause low blood pressure

Looks like bruises but is indicative of blood vessel damage

Yes

CO2 levels are being monitored to detect the cryptic septic shock

Inability of the patient to normalize organ function despite the attempts to correct imbalances. Also patients at this stage are more likely to die than those with other stages of presentation

Mycoplasma and archaea

• Lack a cell wall
• Produced by antibiotic action
• Wall may reform
• Associated with SBE

• SBE = Subacute Bacterial Endocarditis
• Requires various antibiotics:
• Beta Cactam which inhibits cell wall formation
• Aminoglycoside - Inhibit protein synthesis
• Idea is you want to attack the cell wall and protein synthesis of the cell cuz not likely to develop resistance 2 both drugs at the same time

• Obligate intracellular pathogens
• Include: rocky mountain spotted fever
• Lack cell wall
• Cannot be cultured artificially

• Similar to rickettsiae as energy parasite
• Have complex life cycle elementary and reticulate bodies
• Cannot be grown artificially, have to be grown in tissue culture

• C. Trachomatis = STD
• C. Pneumoniae = Pneumonia
• C. Psittacii = Ornithosis/psittacosis

• Lack cell walls
• Contain streols in the cell membrane - unusual for prokaryotes, typical in eukaryotes

• M. Pneumoniae = Primary atypical pneumonia
• M Urealitycum = Genital Mycoplasma
• Non Specific urethritis

• Ancient bacteria
• Cell walls lack peptidoglycan
• Have Pseudomurein
• Include Halophiles, Thermophiles, Methanogens
• Not human pathogens since conditions are not appropriate for growth

• Any patient who has an infectious process (like uti) cuz it can spread into blood and become sepsis and septic shock
• All critically ill patients
• Severe CAP (community-acquired pneumonia)
• Intra-abdominal surgery
• Meningitis
• Chronic diseases (including diabetes, heart failure, chronic renal failure, and COPD)
• Compromised immune statues (including HIV/AIDS, use of cytotoxic and immunosuppressive agents, alcoholism)
• Cellulitis
• Urinary tract infection

• ICU - where 1/10 admissions to the ICU involves severe sepsis
• Unit Admission (criteria)
• Admission assessment
• Nurse shift changes - to combat this you write notes and have reports to insure continuity of treatment
• Existing care protocols and pathways
• Multidisciplinary rounds - Ground runs = patient is critically ill and all specialties are involved
• Deterioration in patients clinical or laboratory paramaters - examine vital signs for deterioration
• Present in ER - 37% of severe sepsis patients present in ER
• Initial assessment
• Pharmacy - combination of therapies can alert the clinical team to possible clinical indicators of severe sepsis
• Antibiotics (infection) + Vasopressor (organ dysfunction)

Early aggressive intervention with supportive after care

• If they have any illness
• Vitals

• Cool pale extemities
• High or very low body temperature - chills
• Lightheadness
• Low blood pressure - especially when standing
• Low urine output - kidney failure
• Palpitations
• Rapid heart rate
• Restlessness, agitation, lethargy, confusion
• Shortness of breath