SEPSIS PATHOPHYSIOLOGY IN 7 SIMPLE STEPS (2018)

Hey there, friend. I'm Christina Rafano from nursingschoolofsuccess.com and in this video, we are going to walk through the pathophysiology of sepsis. Yes, those are two tough concepts in nursing school, pathophysiology and sepsis. But don't worry, I'm going to break all this stuff down into seven simple steps so that you can actually understand it. And of course, I have a free cheat sheet just for you to actually help you remember all this stuff. So be sure to stay until the very end of the video and I will let you know where you can snag that. Now, if you like nursing school information broken down step by step for you like this, let me know in the comments below by commenting with the word love. L O V E. I need to know if you want more videos like this. So if you do, comment below with the word love. Oh, and don't forget to subscribe and hit that bell. So you never miss out on any other free stuff that I've got for you because you don't want to miss out on any of it. So make sure to subscribe and hit that bell. All right, let's dive into sepsis. I've broken down this process into seven steps for you to follow to make it a little easier for you. Now, you won't see these steps in a textbook or anything like that. I just made them up for you to make learning all of this a lot easier. So let's go through the seven steps for sepsis. So sepsis can occur after the body has been invaded by a pathogen, like a bacteria, a virus, fungi, or something like that. We'll call these bad guy pathogens. So these are bad guy pathogens. So when the bad guy pathogens enter the bloodstream, the body puts out an alert to the immune system to tell the immune system that it's being invaded by all these pathogens. And this is step number one of sepsis, where the bad guy pathogens enter the bloodstream. The body puts out an alert to the immune system that it's been invaded. And now step two, the immune system is going to go full force on these guys to try to get rid of them. So it's going to send the whole army of white blood cells to go and take care of the bad guy pathogens. Now, these white blood cells are kind of fun. They have weapons called inflammatory mediators and cytokines, so namely interleukins, tumor necrosis factor, interferons and histamine. And these white cells will release These weapons into the blood, which leads me to step number three of sepsis. These weapons that the white blood cells release cause three things to. They trigger the blood vessels to dilate, which is called vasodilation. It triggers the blood capillaries to actually kind of separate and leak out blood and fluid, which is called capillary leak. And it causes the blood to actually clot. So this vasodilation and capillary leak causes the blood pressure to drop and it causes swelling. There's less blood that's actually going to the body's organs because that blood is leaking out into the surrounding tissues and because the blood is also clotting. Remember that third thing that the white blood cell weapons do is cause that blood to clot. The blood can't get to the organs it needs because all that blood is clotting. And this also decreases the blood supply to the organs as well. So here's the biggest problem, and this is step number four of sepsis. The organs are not getting the blood that they need. And this is because of these inflammatory mediators. Remember those weapons the white blood cells are carrying? These inflammatory mediators cause vasodilation, capillary leak, and blood clotting. So as sepsis continues, the organs aren't getting the blood flow that they need, and therefore the organs don't have the oxygen that they need. So the organs actually start to die. And on top of all this, because the body is not getting the oxygen it needs to function, metabolic ac acidosis can occur, which is step 5 of sepsis. Metabolic acidosis. Now, metabolic acidosis means that the ph of the blood is too low, meaning that it is acidic. So the blood is acidic. And this can happen during sepsis because the organs aren't functioning like they should, and they can't get rid of all the carbon dioxide and the lactic acid and all the waste products that build up. These are all acidic. Plus the kidneys usually make bicarbonate, which is a base to help. But the kidneys aren't getting the blood they need, so they can't function well enough to make bicarbonate to balance out that ph. So the blood becomes more and more acidic. And this can be really, really bad if it's not fixed. So the brain, the kidneys, the heart, the liver, and all the other organs in the body just aren't getting the blood that they need to function because there's so much of that vasodilation, capillary leak, and blood clotting. And the blood is now becoming more and more Acidic, which can lead to metabolic acidosis. So you've probably heard of septic shock too, and you're probably wondering, well, how does that fit into all this? When does septic shock happen? Well, septic shock is actually step six and septic shock is sepsis, but it takes it one step further. In septic shock, sepsis is occurring, but it's not responding to treatment with fluid. So if we catch a patient with sepsis, give them enough fluid, that would usually help them to get better, and their blood pressure actually does not improve, then that is considered septic shock. So for sepsis, we do what is called a fluid resuscitation, which means that they get 30 milliliters of fluid per kilogram of their body weight. So if they have sepsis and their blood pressure is not getting better with that fluid resuscitation and they need stronger meds to help keep their blood pressure up, then they are considered to be in septic shock. So that's where that fits in. Now, kind of the last stage of sepsis, step seven is called multiple Organ Dysfunction syndrome, or MODS for short. And this happens when two or more of the patient's organs have failed. So sepsis has continued. The organs aren't getting the blood, the oxygen and the nutrients that they need to function, so they have stopped working. So multiple organ dysfunction syndrome happens when two or more of the patient's organs have just seen stopped working. Alright, I know that was a lot. So let's recap because that was a lot of information. So when a pathogen enters the bloodstream, the body's inflammatory response kicks in and it's triggered, which is step number one and step number two, the white blood cells are going to go out and hit those pathogens with inflammatory mediators, which are basically weapons. And during step number three, these weapons cause three things to happen. Vasodilation, capillary leak and blood clotting. And all three of these factors then cause less blood to be delivered to the body's organs and the organs stop functioning, which is step number four. So step number four happens when there is just not enough blood flow to the organs. And step number five, if sepsis continues, metabolic acidosis can happen, meaning that the body's PH is just too acidic. Step six is septic shock, which occurs if we give the patient enough fluids, but they're not responding and they're not responding to that fluid treatment, and that's considered septic shock. And if it gets even worse, they can go into step seven, which is mods, Multiple Organ dysfunction syndrome where two or more of the organs have stopped functioning. All right friend, great job. I know that was a lot of information that I just threw at you. So be sure to print out the free cheat sheet that we have for you so that you can always remember these things steps. Whether you're at clinical, maybe you're at skills lab or lecture class or anywhere else you need it. So I will put a link in the description below this video. Now I want to hear from you. If you like step by step guides for nursing school like this, let me know in the comments below by commenting with the word love. L O V E. I need to know if you want more videos like this. So if you do comment below with the word love and if you liked this video make sure to hit that like button. Share it with all your friends. And of course course be sure to click subscribe and hit the bell so you never miss a video. Thank you for watching friend so much. Thank you for being here. And now go become a nurse that God created only you to be. And I will see you next time here on the Nursing School show.