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?

Choice A reason: 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 reason: 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 reason: 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 reason: 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 reason: 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.

Choice C reason: 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 A reason: 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 reason: 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 D reason: 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.