MEDizzy - A 65-year-old man undergoes a low anterior resection for

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Pre- and Postoperative Care II

A 65-year-old man undergoes a low anterior resection for rectal cancer. On the fifth day in hospital, his physical examination shows a temperature of 39°C (102°F), blood pressure of 150/90 mm Hg, pulse of 110 beats per minute and regular, and respiratory rate of 28 breaths per minute. A computed tomography (CT) scan of the abdomen reveals an abscess in the pelvis. Which of the following most accurately describes his present condition?

ExplanationB. The correct diagnosis is sepsis. Systemic inflammatory response syndrome (SIRS) involves 2 or more of the following: temperature >38°C (100°F) or <36°C (97°F), heart rate >90 beats per minute, respiratory rate >20 or PaCO2 <32 mm Hg, WBC count >12,000 or <4000/mm3 or >10% immature neutrophils. Sepsis = SIRS + documented infection. Severe sepsis = sepsis + organ dysfunction or hypoperfusion (lactic acidosis, oliguria, or altered mental status). Septic shock = sepsis + organ dysfunction + hypotension (systolic blood pressure <90 mm Hg or >90 mm Hg with vasopressors).