Nursing 4440A/B Lecture Notes - Lecture 8: Acute-Phase Protein, Septic Shock, Antithrombin Iii Deficiency

• School: Western University
• Department: Nursing
• Course: Nursing 4440A/B
• Professor: Mary-Anne Davies

Document Summary

International practice guidelines developed to reduce sepsis mortality worldwide. Diagnosis: serum procalcitonin (pct) can allow for early diagnosis, serum lab test that evaluates systemic bacterial infections, can differentiate bacterial, viral, or parasitic, normal range <0. 05ng/ml. Pct of 0. 05 to 1. 9ng/ml indicate localized infection, Low count seen in intravascular coagulation: coagulation cascade, antithrombin deficiency, prolonged prothrombin time, inr. >1. 5: abnormalities observed before organ familiar and without frank bleeding, creatine >0. 5mg/dl or 44. 2mmol/l, doubling indicates acute renal injury. Liver enzymes, elevated phosphates, transaminase, aminotransferase and bilirubin. Indicates hepatic cell injury, caused by hypo perfusion: serum phosphate, hypophosphatemia (<2. 5mh/dl or 0. 8mmol/l) Inverse correlation with proinflammatory cytokines: c-reactive protein, >40mg/l, in severe cases >200mg/l, acute phase response, pct, >2ng/dl indicative of sepsis, >10ng/dl indicates septic shock, differentiates infectious inflammatory response syndrome from. If lung sounds stable bolus repeated every 20-30 minutes until cvp at least 8.