0



On the Continuum Bundle Elements Screening and Protocol Time Matters Critical Thinking
100
What is severe sepsis?
Name the stage on the sepsis continuum at which we implement the bundle?
100
What is blood cxs x2 and lactate?
A patient presents with severe sepsis at 14:35. Name the nurse-driven bundle elements that do not require a physician order.
100
What is every shift, on admission/transfer, with change in condition?
Name the times we are required to screen for sepsis.
100
What is 12 hrs?
Over what timeframe are nurses expected to review vitals and lab data to assess for sepsis?
100
Chain of command, charge RN/lead nurse, sepsis champion, surveillance team, subject matter expert, medical chain of command.
Your patient screens positive for severe sepsis, but is already on broad-spectrum antibiotics since admission for spontaneous bacterial peritonitis prophylaxis. You initiate the severe sepsis bundle but the provider says "He's covered."and does not want to order additional antibiotics. Name a resource available to help you advocate for appropriate treatment.
200
What is sepsis?
Your transplant patient is immunosuppressed and returns to the floor after a liver biopsy with rigors, a fever of 38.3, HR 125. BP is 130/80 unchanged from baseline. Name the stage on the sepsis continuum.
200
What is Zosyn?
Zosyn and Vancomycin are often ordered simultaneously. If you have a line access issue, this medication should be given first.
200
What is SBAR?
This communication technique is recommended when informing a provider of a positive severe sepsis screen because it yields all pertinent data in a prompt and standardized manner.
200
What is 18:15?
Your patient presents with septic shock, lactate 41 drawn @ 15:15, the level resulted at 16:00 in CareConnect. Name the time at which the repeat lactate should be drawn.
200
What is vasodilation or leaky capillaries?
Your patient screens positive for septic shock. You anticipated the provider to order a weight-based fluid bolus of NS or LR, but instead, they order 250 mL NS x1. Name one reason why this bolus would be insufficient to reestablish perfusion to vital organs.
300
What is mechanical ventilation or BiPap?
Name one criteria of acute respiratory organ dysfunction that would qualify a patient for severe sepsis.
300
What is IVF bolus or fluid resuscitation?
This medication was once an initial bundle element. Now it is only required for patients in severe sepsis or shock with hypotension or lactate = or > 36.
300
What is 8 mL?
If you don’t draw this minimum volume of blood in each bacterial culture bottle, you could end up with a false negative result.
300
What is 48 hrs?
Your patient is being treated for urosepsis with the severe sepsis bundle last activated yesterday. What is the window of time to continue current treatment before a redo of the bundle is warranted if he screens positive again?
300
B) Informing the provider and advocating for cultures and antibiotics. Activate the nurse-driven protocol only when the patient meets criteria for severe sepsis or septic shock.
A patient screens negative for severe sepsis, however has shown a change in condition with fever 38.5 and new AMS. You suspect an infection with malodorous, turbid urine. All other VS are within the patient's baseline. Name the action that is more appropriate: A) Activating the nurse-driven severe sepsis protocol or B) informing the provider and advocating for cultures and antibiotics
400
What is BP 88/50?
Your patient presents with chills, rigors and lethargy. You review his vitals. Name the vital sign that makes him qualify for severe sepsis and not SIRS. HR 120, temperature of 38.1, RR 31, BP 88/50, WBC 3.5.
400
What are vasopressors?
You implement the severe sepsis bundle on your patient who becomes hypotensive with lactate of 21, but they are unable to tolerate fluid resuscitation due to CHF. Name 1 alternative bundle element required to address the hypotension.
400
What is initiate vasopressors?
You implement the severe sepsis bundle on your patient who becomes hypotensive with lactate of 21, but they are unable to tolerate fluid resuscitation due to CHF. Name 1 alternative bundle element required to address the hypotension.
400
What is 17:39?
If the TOP (time of presentation) is 16:39, this is the latest time we can administer the broad-spectrum antibiotic before we are out of compliance.
400
A) Broad Spectrum Antibiotics. Never delay treatment with broad-spectrum antibiotics.
Your patient screen positive for severe sepsis but is a difficult stick and only 1 bacterial culture has been obtained. You receive the antibiotics in hand. The current time is 16:50, TOP 16:00. Name the priority for severe sepsis treatment: A) broad spectrum antibiotics B) 2nd bacterial culture and lactate.
500
What is septic shock and vasopressors?
It is 15:13. A patient is transferred to your unit, chief complaint on admission: vomiting, fever and diarrhea x3 days. History of small bowel transplant and multiple episodes rejection and line infection. You review the Sepsis Audit Graph and see over the last 6 hours, temp increasing to 38.5, HR increasing from 80s to 131, BP 85/47. You activate the nurse-driven severe sepsis protocol and treat accordingly. After administering fluid resuscitation, the patient is still hypotensive. Name the stage on the continuum that the patient is currently presenting and what should be initiated next?
500
What is volume and tissue perfusion assessment?
This bundle element is often forgotten by the physicians but is required DOCUMENTATION after a patient is treated for septic shock.
500
Patient LH acutely confused. Liver eval 2/2 ETOH cirrhosis possible UTI, turbid malodorous urine, febrile 38.5, other VSS. sepsis negative. Would you like to assess at bedside and culture? order antibiotics?
Patient LH history of ETOH cirrhosis here for transplant eval, screens negative for severe sepsis, however has shown a change in condition, fever of 38.5 and new AMS. You suspect an infection because the patient's urine is turbid and malodorous. All other vital signs are within normal limits. Give an example using SBAR of how you would communicate this to the provider.
500
What is 12:15?
Your patient is being treated for community acquired pneumonia. You notice new onset lethargy and confusion at 12:15. On the sepsis audit graph you see HR > 90 @ 11:00, temp 39.5 @ 12:00. Name the time of presentation.
500
Have the provider document rationales for any deviation from the protocol (document leukocytosis as chronic; document this is not severe sepsis); Consult your resources (chain of command, SME, surveillance team, sepsis champion.) Use your CUS words.
A patient with sickle cell disease screens positive for severe sepsis based on an uptrending HR into the 130s, WBCs 38k up from 30k previous day, and rising Cr > 2. The provider does not want to start antibiotics saying the patient has a history of leukocytosis likely related to sickle cell with multiple cultures negative to date. His attending does not want to start antibiotics. Name one action that would be necessary to take to prevent a fallout.




Sepsis Day Jeopardy

Press F11 for full screen mode




Edit | Download / Play Offline | Share