Question

1 surviving sepsis i was working as a nurse in an emergency department. a medical transport team brought in a patient from a long - term care facility. the elderly man was lethargic and required a lot of stimulation before he could respond to my questions. the attendant who accompanied the patient reported he had become drowsier in the past 2 days, causing concern for his caregivers. that morning, his blood pressure was low so the patient was transported to the hospital for further assessment. in the emergency department, his blood pressure and oxygen saturation levels were low. the patient had a high fever. his pulses were weak and heart rate was rapid. i applied oxygen mask to the patient with 10 liters of flow. the provider ordered intravenous (iv) fluids to be given quickly as a bolus. another nurse obtained iv access and started the fluids. i called the pharmacy to notify them that we suspected the patient had septicemia and needed stat antibiotics. next, i prepared to draw labs from the patient. the provider requested a full laboratory workup, including blood and urine cultures. the provider also requested a serum lactate level. knowing this required special precautions for collection, i obtained supplies for a free - flowing sample and prepared to send it immediately to the laboratory for processing. i obtained blood cultures immediately before the antibiotic doses arrived. in low oxygen states, the body uses other sources of energy. when organs are unable to extract the oxygen they need for energy production, the body converts to anaerobic metabolism to produce atp. the by - product of this process is lactic acid. high levels of lactic acid can alter the patients blood ph—a state called lactic acidosis. generally a high serum lactate level indicates poor organ function. prompt identification and treatment of sepsis is associated with better outcomes and decreased mortality. the priority for sepsis management is early fluid resuscitation and antibiotic administration. it is essential to support hemodynamics (blood pressure and perfusion) to ensure adequate oxygen delivery to body tissues and prevent further organ damage. in this case, the nurse correctly prioritized collection of body fluid samples for culture while waiting for the arrival of antibiotics. collecting these samples after antibiotics have been given may alter the growth of bacteria, clouding the picture for treatment of a specific organism. patients with septicemia are treated with broad - spectrum antibiotics until the specific causative organism is identified. concept check 1. why did the patients lactate levels rise? the lactate levels increased due to aerobic metabolic reactions the lactate levels increased due to oxygen saturation increases the lactate levels increased due to increased blood pressure the lactate levels increased due to anaerobic metabolic reactions 2. what does the increase in lactate do to blood ph?

Explanation:

1. In low - oxygen states, the body uses anaerobic metabolism to produce ATP and lactic acid is the by - product. So, the lactate levels increase due to anaerobic metabolic reactions.
2. High levels of lactic acid can alter the patient's blood pH. Lactic acid is acidic, so an increase in lactate decreases blood pH.

Answer:

1. The lactate levels increased due to anaerobic metabolic reactions
2. Decreases blood pH