Sepsis a Case Study

3132 Words Jan 14th, 2014 13 Pages
The aim of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format.
To maintain patient confidentiality any identifying features have been removed in keeping with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (NMC, 2008) the patient will be referred to as Mr X.
Mr X was an 80-year-old male admitted to ITU, from the Medical Assessment Unit, with increasing respiratory failure.
His
…show more content…
Table 2 Nutbeam et al 2009 mediators, causing increasing capillary permeability and widespread fluid shift into the interstitial space, which was no longer functioning to maintain vascular volume (known as third spacing) in addition, causing further vasodilation to occur.
This caused Mr X to become increasingly hypotensive and tachycardic.
Table 2 shows some of the chemical mediators involved in Mr X’s inflammatory process, causing it to become more severe and uncontrolled, resulting in a further decline in his clinical presentation.
His clinical observations were now: Blood Pressure: 80/50mmHg
MAP: 55mmHg
Heart Rate: 130 beats per minute
The patient was now diagnosed as being in septic shock. His skin was mottled with an increasing capillary refill time. Schmidt and Mandel (2008) suggest this is a sign of hypoperfusion as the skin is vasoconstricting due to the redirection of blood flow to the core organs.
I informed the doctor and expressed my concerns regarding the patient’s hypotension.
A 250ml fluid bolus of colloid was given as an attempt to improve Mr X’s blood pressure and MAP.
The early intravenous fluid administration for resuscitation of the critically ill hypovolemic patient is the corner stone of shock therapy (Kruemer & Ensor 2012). The Surviving Sepsis recommends early optimization in the first six hours, followed with fluid challenges in the case of persistent hypo…

More about Sepsis a Case Study