Review Infection and Sepsis

Basic Concepts of Pathophysiology > Pathophysiology

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Infection and Sepsis

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Total Questions : 5

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Question 1:

A nurse is caring for a client who has a urinary tract infection (UTI) caused by Escherichia coli. The nurse understands that this is an example of what type of infection?

A. Nosocomial infection B. Opportunistic infection C. Community-acquired infection D. Latent infection

Answer and Explanation

Choice A:

Nosocomial infection is an infection that is acquired in a health care setting, such as a surgical site infection or a catheter-associated bloodstream infection. Nosocomial infections are often caused by multidrug-resistant organisms, such as methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE).

Choice B:

Opportunistic infection is an infection that occurs in immunocompromised individuals, such as those with HIV/AIDS, cancer, or organ transplantation. Opportunistic infections are caused by microorganisms that are normally harmless or part of the normal flora, but become pathogenic when the host's defenses are weakened. Some examples of opportunistic infections are Pneumocystis jirovecii pneumonia, Candida albicans thrush, or cytomegalovirus retinitis.

Choice C:

Community-acquired infection is an infection that is acquired outside of a health care setting, such as a UTI caused by E. coli. E. coli is a common cause of UTI and is usually found in the intestinal tract or fecal matter.

Choice D:

Latent infection is an infection that remains dormant or inactive in the host for a period of time, but can reactivate and cause disease when the host's immunity declines. Some examples of latent infections are herpes simplex virus, varicella-zoster virus, or Mycobacterium tuberculosis.

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Question 2:

A nurse is teaching a client who has sepsis about the pathophysiology of the condition. Which of the following statements should the nurse include in the teaching? (Select all that apply.)

A. "Sepsis is a life-threatening condition that occurs when your body has a systemic inflammatory response to an infection." B. "Sepsis can cause organ dysfunction or failure due to impaired tissue perfusion and oxygen delivery." C. "Sepsis can be diagnosed by measuring your blood lactate level, which indicates the severity of tissue hypoxia." D. "Sepsis can be prevented by taking antibiotics regularly and avoiding contact with sick people." E. "Sepsis can be treated by administering fluids, vasopressors, oxygen, and antibiotics as soon as possible."

Answer and Explanation

Choice A:

Sepsis is a life-threatening condition that occurs when the body has a systemic inflammatory response to an infection, which can be bacterial, viral, fungal, or parasitic. The inflammatory response involves the activation of immune cells, cytokines, complement, coagulation, and fibrinolysis pathways that cause widespread vasodilation, increased vascular permeability, and microvascular thrombosis.

Choice B:

Sepsis can cause organ dysfunction or failure due to impaired tissue perfusion and oxygen delivery. The vasodilation and increased vascular permeability cause hypotension and hypovolemia, which reduce the cardiac output and blood pressure. The microvascular thrombosis causes obstruction and ischemia of the capillaries, which impair the oxygen and nutrient exchange to the tissues. The tissue hypoxia causes anaerobic metabolism and lactic acidosis, which further worsen the organ function.

Choice C:

Sepsis can be diagnosed by measuring the blood lactate level, which indicates the severity of tissue hypoxia. Lactate is a product of anaerobic metabolism that accumulates in the blood when the oxygen delivery to the tissues is insufficient. A normal blood lactate level is less than 2 mmol/L. A blood lactate level of 2 to 4 mmol/L indicates moderate tissue hypoxia and sepsis. A blood lactate level of more than 4 mmol/L indicates severe tissue hypoxia and septic shock.

Choice D:

Sepsis cannot be prevented by taking antibiotics regularly and avoiding contact with sick people. Taking antibiotics regularly can increase the risk of antibiotic resistance and superinfection by killing the normal flora and allowing opportunistic pathogens to grow. Avoiding contact with sick people can reduce the exposure to infectious agents, but it cannot eliminate the risk of sepsis completely, as some infections can be asymptomatic or latent.

Choice E:

Sepsis can be treated by administering fluids, vasopressors, oxygen, and antibiotics as soon as possible. Fluids are given to restore the intravascular volume and improve the tissue perfusion and oxygen delivery. Vasopressors are given to increase the blood pressure and maintain the vital organ function. Oxygen is given to correct the hypoxemia and reduce the tissue hypoxia. Antibiotics are given to eradicate the causative microorganism and control the infection.

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Question 3:

A nurse is assessing a client who has severe sepsis. The nurse observes that the client has tachycardia, hypotension, oliguria, and altered mental status. The nurse understands that these findings are indicative of what type of organ dysfunction?

A. "Cardiac dysfunction." B. "Renal dysfunction." C. "Neurologic dysfunction." D. "All of the above."

Answer and Explanation

Choice A:

Cardiac dysfunction is indicated by tachycardia and hypotension, which reflect the impaired cardiac output and blood pressure due to sepsis. The cardiac dysfunction can lead to cardiogenic shock, myocardial ischemia, or arrhythmias.

Choice B:

Renal dysfunction is indicated by oliguria, which reflects the reduced renal perfusion and glomerular filtration rate due to sepsis. The renal dysfunction can lead to acute kidney injury, electrolyte imbalance, or metabolic acidosis.

Choice C:

Neurologic dysfunction is indicated by altered mental status, which reflects the reduced cerebral perfusion and oxygenation due to sepsis. The neurologic dysfunction can lead to delirium, coma, seizures, or stroke.

Choice D:

The client has signs and symptoms of cardiac, renal, and neurologic dysfunction due to sepsis.

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Question 4:

A nurse is caring for a client who has a wound infection caused by Staphylococcus aureus. The nurse notes that the wound has a creamy white or yellow, purulent, and sometimes bloody drainage. The nurse recognizes that this type of drainage is indicative of what type of exudate?

A. Serous exudate B. Sanguineous exudate C. Purulent exudate D. Fibrinous exudate

Answer and Explanation

Choice A:

Serous exudate is a type of exudate that contains clear or yellowish fluid that accumulates in body cavities or on the surface of tissues. It has a watery and thin appearance and no odor. It is seen in conditions such as blisters or pericarditis.

Choice B:

Sanguineous exudate is a type of exudate that contains blood or blood cells that leak from damaged blood vessels. It has a red or brown appearance and no odor. It is seen in conditions such as trauma, surgery, or malignancy.

Choice C:

Purulent exudate is a type of exudate that contains pus, which is composed of dead neutrophils, bacteria, and cellular debris. It has a creamy white or yellow, purulent, and sometimes bloody appearance and a foul odor. It is seen in wound infections caused by pyogenic bacteria, such as S. aureus.

Choice D:

Fibrinous exudate is a type of exudate that contains fibrin, which is a protein that forms a meshwork of fibers that seal and stabilize the wound. It has a sticky and thick appearance and no odor. It is seen in conditions such as rheumatic fever or pleurisy.

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Question 5:

A nurse is administering antibiotics to a client who has septic shock. The nurse understands that the goal of antibiotic therapy in septic shock is to achieve what outcome?

A. Eradicate the causative microorganism within 24 hours B. Reduce the inflammatory response within 48 hours C. Restore the tissue perfusion and oxygen delivery within 72 hours D. Prevent the development of multiple organ dysfunction syndrome within 96 hours

Answer and Explanation

Choice A:

A benign neoplasm grows slowly and remains localized within its site of origin. It does not spread to other parts of the body or cause systemic effects.

Choice B:

A malignant neoplasm invades surrounding tissues and organs and destroys their normal function. It can also penetrate blood vessels or lymphatics and disseminate to distant sites, forming secondary tumors or metastases.

Choice C:

A benign neoplasm can differentiate into normal cells that resemble the tissue of origin. It has a well-defined shape and structure and retains some of its normal functions.

Choice D:

A malignant neoplasm can metastasize to distant sites via blood or lymph, creating new foci of tumor growth and increasing the complexity and severity of the disease.

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Infection and Sepsis

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