Infection and Sepsis: When the Security Gate Goes to War
Infection happens when a pathogen breaches the cell membrane security gate. The immune factory launches a response. That response — inflammation — is protective at low levels and destructive at high levels. Sepsis is what happens when the inflammatory response becomes so massive that it damages the factories it was trying to protect.
Pathogen enters
→
Immune response activated
→
Inflammation
→
Vasodilation, capillary leak
→
Hypotension → Septic shock
| Cue | Early Sepsis | Septic Shock |
|---|---|---|
| Temperature | Fever >38.3°C OR hypothermia <36°C | Often hypothermia — factory cooling down |
| Heart rate | Tachycardia >90 bpm | Severely elevated or dropping |
| Respiratory rate | Tachypnea >20 | Very rapid — metabolic acidosis driving breathing |
| Blood pressure | May be normal or slightly low | SBP <90 mmHg despite fluids — emergency |
| Mental status | Restlessness, mild confusion | Profound confusion, unresponsiveness |
| Urine output | Decreasing | <0.5 mL/kg/hr — kidney factory shutting down |
NGN Cue Recognition: Sepsis questions test whether you recognize the cue cluster. A patient with fever + tachycardia + tachypnea + new confusion = report to RN immediately. The LPN does not wait for all signs to be present — a change in mentation alone in a patient with known infection warrants immediate reporting.
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