Certified Wound Ostomy Nurse (CWON) Practice Test

How might phase 2 of necrotizing fasciitis present systemically?

1. Abdominal pain and cramping

2. Increased fever and chills

3. Altered mental status

4. Cold extremities

The correct answer is: Altered mental status

Phase 2 of necrotizing fasciitis is characterized by an increase in systemic symptoms as the infection progresses and can lead to significant physiological changes. The presentation of altered mental status is particularly critical in this context as it can be indicative of systemic effects, such as septic shock or severe metabolic disturbance. As the body responds to the infection, there can be a resultant release of cytokines and inflammatory markers that affect the central nervous system functions. This alteration can manifest as confusion, disorientation, or even decreased levels of consciousness, which are vital signs of a patient's deteriorating condition. Recognizing altered mental status is essential for timely intervention, as it can suggest that the sepsis is severe enough to impact brain function due to inadequate perfusion or the effects of toxins in the bloodstream. While increased fever and chills, abdominal pain, and cold extremities can all be associated with various infections and conditions, altered mental status is uniquely significant in the context of necrotizing fasciitis and its potential systemic consequences. It signals a more immediate need for critical clinical evaluation and intervention due to the grave implications for the patient’s overall health status.