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
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.
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