SEPSIS:

-a bacterial infection that is widespread throughout the bloodstream, aka septicaemia

-uncommon, occurs when there is already an infection present within the skin, lungs,
abdomen, urinary tract, can occur when foreign objects are present such as catheters,
IV, drainage tube, etc.
-also occurs when surgery is performed on an infected area or part of body where
bacteria grow such as the intestines
-can be life threatening if proceeds to septic shock (BP falls very low and causes organs
to malfunction d/t decreased oxygen
-further infections can occur if circulating bacteria enter other parts of the body such as
the tissues surrounding the brain, heart, bones, joints
Symptoms/Diagnoses:
-sudden fever w/ infection, shaking, chills, fever, N/V/D, weakness and confusion
-treated with antibiotics (ASAP) sometimes before cultures taken, 2-3 at a time to
effectively kill bacteria (common drug is drotrecogin alfa-prevents inflammation and
clotting) sometimes infection has to be surgically removed

UROSEPSIS:
-bloodstream infection from UTI’s – increased frequent urination
-burning sensation, flank pain, blood in urine, fever present, pulse/heart rate increased
-treated by antibiotic therapy and vasopressors and fluid replacement

CHF:
-hearts pumps blood inadequately leading to reduced blood flow, back-up of blood in the
veins and lungs, other changes that further weaken the heart
-common in older people and those with high risk (lifestyle) there are many reason why it
happens, can be compensation mechanisms (hormones released after MI that damage
the heart) systolic and diastolic dysfunction, symptoms develop days to months
Symptoms/Diagnoses:
-weak and tired during ADL’s, signs of confusion, lethargy, dizziness,
-Right Sided: fluid accumulation and edema in feet, ankles, legs, liver, abdomen (causes
loss of appetite and nausea)
-Left Sided: fluid accumulation in lungs causing SOB, sometimes respiratory distress,
rapid breathing, bluish skin, airway spasms, anxiety, eventually left sided causes right
sided heart failure
-rapid pulse, low BP, swollen veins, auscultation of lungs abnormal sounds d/t fluid
-many drugs, sometimes loop diuretics when sodium reduction fails, initially use ACE
inhibitors later Beta blockers which will worsen symptoms then produce long term results
-also anticoagulants such as digoxin, oxygen masks, etc.

FEBRILE NEUTROPENIA:
-occurs w/ many cases of neutropenia (low neutrophil granulocytes in the blood
-considered a medical emergency Def’n: fever accompanying an infections is often a
complication of chemotherapy treatment when it is myelosuppressive (suppresses the
bone marrow from producing blood cells)
-complications of neutropenia: death, ICU admission, confusion, cardiac complications,
resp failure, renal failure, hypotension, bleeding
-treated with empirical antibiotics until the neutrophil count has improved
SYNCOPE:
-fainting, caused by inadequate blood flow due to abnormal heart rate or rhythm,
symptoms can also result from brain or spinal cord disorders

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ATRIAL FIBRILLATION:
-fast electrical discharge that cause the atria to contract rapidly, the electrical impulses
can reach the ventricles causing them to contract faster and, less efficient than normal,
can be intermittent or sustained
-atria do not empty completely into the ventricles over time = stagnant clotted blood
which can become emboli when passed and can block arteries resulting in CVA
Symptoms/Diagnoses:
-chest discomfort, irregular and fast pulse, reduces pumping ability causes weakness,
faintness and SOB can develop into heart failure and chest pain. Various drugs used to
treat, usually anticoagulants, beta blockers, antiarrhythmics
-most effective approach is cardioversion or defibrillation (electric shock to the heart)

PNEUMONIA:
-infection of the small air sacs around the lungs (alveoli) and the tissues around them
-community, hospital or institution acquired (knowing where tells infectious source
-bacteria is inhaled into lungs/ carried into lungs by bloodstream/ migrates in the lungs
directly by a nearby infection, can also follow surgery
-aspiration pneumonia: particles inhaled into mouth and not cleared
-obstructive pneumonia: obstruction (tumour) causes bacteria to become trapped
Symptoms/Diagnoses:
-cough that produces sputum, chest pain, thrills, fever, SOB, abnormal chest sounds,
-Dx confirmed by CXR, cultures, sometimes bronchoscopy
-Tx: prevented by vaccines, deep breathing to clear secretions, and antibiotics (many)

FAILURE TO COPE/THRIVE:
-delay in physical growth and weight gain resulting in developmental delays and
malnutrition, can be the result of environmental, emotional, physical, and medical factors
-treatment depends on the underlying cause. Mild to moderate failure is treated with
nutrition and high calorie feedings by parents, more severe treated in the hospital (team)

CELLULITIS:
-spreading bacterial infection directly under skin and tissues, caused mainly by
streptococcus species (hinders ability of skin to confine infection) enters thru small
breaks in the skin, common in legs but can be anywhere
Symptoms/Diagnoses:
-redness, pain, tenderness, skin becomes hot slightly swollen and may become pitted,
sometimes fluid filled blisters small (vesicles) or large (bullae); edges of infection can be
raised. Pts may complain of fever, chills, rapid heart rate, headache, low BP, confusion
-prompt treatment w/ antibiotics prevent rapid infection either oral or IV (if severe)
symptoms will worsen before the improve (bacterial death causes release of damaged
tissues) cool/wet dressing to relieve discomfort

DVT:
-blood clots (thrombi) in the deep veins, in the deep leg veins, or superficial leg veins
(less harmful b/c does not turn into emboli)
-causes little inflammation, less meaning thrombus is not adhered to the vein and can
move, travel down bloodstream blocking an artery
-causes: injury to veins lining, increased tendency for blood to clot, slow blood flow

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 Symptoms/Diagnoses:
-pulmonary embolism first indication, calves can swell and be painful, tender to touch
and warm, ankle, foot or thigh may swell depending on vein infected, edema (usually
worse towards end of day b/c blood has to travel upward against gravity
-Doppler Ultrasonography used to detect clots in legs
-those at risk should flex and extend ankles 10 times every 30 min, wear support hose,
anticoagulant therapy is used

SEIZURE:
-periodic disturbances of the brain’s electrical activity resulting in temporary brain
dysfunction, seizures before age 2 care caused from high fevers and metabolic
disorders such as abnormalities in the blood levels, recurring seizures are likely
hereditary brain disorders (epilepsy), if they occur in adulthood possible cause is trauma
to brain
Symptoms/Diagnoses:
-unusual smell, taste, vision, or intense feeling (aura) that seizure is coming
-last from few seconds to minutes (2-5min) when it stops person complains of headache,
sore muscle, confusion, fatigue
-treatment if cause is known usually solved if seizure was isolated,
-anticonvulsants given to those at risk for more seizures, exercise is recommended
-brain surgery is only an option when all others have failed

RENAL FAILURE:
-kidneys cannot adequately filter waste products from the blood (such as creatinine and
blood urea nitrogen) many possible causes kidney decline, trauma or injury, obstruct…
Symptoms/Diagnoses:
-depends on severity, rate of progression, underlying cause
-1st is fluid retention in ankles, legs, puffiness in face and hands, cola coloured urine,
output decreases, little (oliguria) none (auria) may experience fatigue, loss of appetite,
itchiness, rapid HR, light headed, cramp pain
-Dx by blood tests for urea, creatinine, usually some decline in RBC’s (anemia) blood
also becomes slight acidic d/t higher level of Potassium
-Tx usually dialysis if criteria met, ACE drugs, specific dietary measure, blood
transfusions for anemia.

UGI BLEED:
-haemorrhage from a source such as esophagus, stomach, duodenum
-hematemesis always reflects UGI, stools can be black (melena) to bright red
(hematochezia)
Symptoms/Diagnoses:
-decreased Hgb and Hct, BP, NG tube aspiration and irrigation,
-assess orthostatic hypotension >10mmHg indicates a > 20% reduction in blood volume,
when blood approaches loss of 40% of blood volume, shock ensues
-endoscopy or colonoscopy to identify location of bleed
-treated by IV fluids, blood transfusions, surgical repairs,