Deck 7: Critical Care Related to the Systemic Inflammatory Response

Question 1

Erin is an 81-year-old lady who has fallen and broken her neck of femur. She has had surgery 2 days ago to fix this. She has an IV cannula leftover from surgery that isn't being used and a urinary catheter until she is able to get out of bed and be more mobile to the toilet.

-Erin has the following observations, Respiratory rate - 22/min; SpO₂ - 94% on nasal cannula oxygen at 3 lpm; Systolic blood pressure - 155 mmHg; Heart rate - 96 bpm; Conscious level - mild confusion (previously she was cognisant); Temperature - 35.8 $\degree$ C. What is her NEWS 2 score?

A) 10
B) 8
C) 7
D) 3

Answer 1

10

Question 2

Erin is an 81-year-old lady who has fallen and broken her neck of femur. She has had surgery 2 days ago to fix this. She has an IV cannula leftover from surgery that isn't being used and a urinary catheter until she is able to get out of bed and be more mobile to the toilet.
-On calculating Erin's NEWS2 score, what would you do?

A) Repeat her observations in an hour's time.
B) Start the sepsis 6
C) Leave it, she looks alright and she's eaten her lunch
D) Talk to a colleague as you're not sure what to do.

Answer 2

B

Question 3

Erin is an 81-year-old lady who has fallen and broken her neck of femur. She has had surgery 2 days ago to fix this. She has an IV cannula leftover from surgery that isn't being used and a urinary catheter until she is able to get out of bed and be more mobile to the toilet.
-If Erin's NEWS2 score is 10 would you consider sepsis?

Answer 3

True

Question 4

Erin is an 81-year-old lady who has fallen and broken her neck of femur. She has had surgery 2 days ago to fix this. She has an IV cannula leftover from surgery that isn't being used and a urinary catheter until she is able to get out of bed and be more mobile to the toilet.

-Based on the presenting case about and symptoms provided, which of the following are risk factors for Erin to be considered for sepsis (tick all that apply)

A) New altered mental state
B) Surgery within the last 6 weeks
C) Raised respiratory rate >21 bpm
D) Systolic blood pressure 155 mmHg.
E) Heart rate >91 bpm
F) Temperature < 36 $\degree$ C
G) Skin mottled or redness around the wound.

Question 5

Erin is an 81-year-old lady who has fallen and broken her neck of femur. She has had surgery 2 days ago to fix this. She has an IV cannula leftover from surgery that isn't being used and a urinary catheter until she is able to get out of bed and be more mobile to the toilet.
-What might be the suspected cause or site of Erin's sepsis?

A) Surgical wound site
B) IV cannula
C) Urinary catheter
D) Pneumonia/chest infection
E) All the above

Question 6

Erin is an 81-year-old lady who has fallen and broken her neck of femur. She has had surgery 2 days ago to fix this. She has an IV cannula leftover from surgery that isn't being used and a urinary catheter until she is able to get out of bed and be more mobile to the toilet.
-What causes sepsis?

A) Inflammation 'gone bad'
B) The heart fails
C) The blood pressure falls
D) There's an infection

Question 7

Erin is an 81-year-old lady who has fallen and broken her neck of femur. She has had surgery 2 days ago to fix this. She has an IV cannula leftover from surgery that isn't being used and a urinary catheter until she is able to get out of bed and be more mobile to the toilet.
-Why is there a loss of fluid from the circulation in sepsis?

A) The person doesn't drink enough
B) The person urinates too much
C) The fluid leaves the circulation entering the extravascular circulation
D) Fluid is not lost from the circulation it doesn't circulate because the heart fails.

Question 8

Arif (68) is feeling unwell at home. He feels hot but is shivering and very tired. He is normally well although he does smoke. He is producing green sputum, which is new, and he is feeling breathless. He has pneumonia.
-Why is Arif shivering?

A) Because he is cold
B) Because he tired
C) Because his hypothalamus has reset to a higher temperature and the body is trying to warm up to that temperature
D) Because his body is trying to shut down.

Question 9

Arif (68) is feeling unwell at home. He feels hot but is shivering and very tired. He is normally well although he does smoke. He is producing green sputum, which is new, and he is feeling breathless. He has pneumonia.
-What effect does his pneumonia have on oxygen uptake in the lungs?

A) It reduces oxygen uptake
B) It increases oxygen uptake
C) No difference
D) Pneumonia does not affect gas exchange in the lungs.