The nurse would identify which patients as being at increased risk for development of sepsis and septic shock? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply

Question

1. A patient admitted from a nursing home for treatment of a stage 4 pressure ulcer
2. A patient with a ruptured viscus who is vomiting bright red blood
3. A patient who takes methotrexate for rheumatoid arthritis
4. A patient who sustained blunt trauma to the spinal cord
5. A patient being treated for aplastic anemia

Answer 1

1,3,5
Rationale 1: Breaches in skin integrity such as pressure ulcers are a risk for sepsis and septic shock.
Rationale 2: Fluid-volume deficit secondary to hematemesis may lead to hypovolemic shock.
Rationale 3: Patients taking methotrexate for chemotherapy or immune modulation are at risk for sepsis and septic shock.
Rationale 4: Blunt spinal cord injury may lead to spinal or neurogenic shock.
Rationale 5: Aplastic anemia is characterized by the suppression of all cellular elements of the bone marrow, including WBCs, which raises the risk of infection and sepsis.