Sepsis help

[RugerNurse]

When does BP become an issue with sepsis? I understand that septic shock is when the patient's BP doesn't respond to fluids and vasopressors are needed but if a patient has sepsis or severe sepsis when does the BP start to drop?

[AnnieOaklyRN, BSN, RN, EMT-P]

Septic shock is when the patient stops compensating and their perfusion decreases (low blood pressure), it has nothing to do with their response to medications given.

Assuming this is homework, please look up the other information and tell us why you think their BP drops.

Annie

[Kareegasee]

It will not drop with sepsis, it will drop when the sepsis continuum progresses to septic shock. The massive vasodilation that occurs as a result of released inflammatory mediators is what causes BP to fall. The amount of blood volume they had before they experienced this vasodilation was adequate to perfuse their organs. Now, their vasculature has expanded, causing a fall in pressure. Their previously normal blood volume is now suddenly inadequate for perfusion due to the lack of pressure related to vasodilation. There is no rule patients follow as to when that will happen, but it is amazing how quickly it can progress. I have taken patients from med-surg floors who have begun showing signs of sepsis, who are dead by the end of my shift. This is why its so important to be knowledgable about the disease process. Septic patients can come from any patient population.

[dream'n, BSN, RN]

You are viewing the question wrong. First you need to understand what sepsis does, why it occurs and how it affects the body. THEN you can critically figure out what type of s/s you would see. If you understand the body process, then you'll understand WHY the BP drops, why the HR increases, etc.