Support Vasopressors Failure System

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.

The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.

Septic shock is the leading cause of death for patients in intensive care units and is the final stage in a continuum of infectious and inflammatory processes. This continuum begins with bacteremia, which is the presence of bacteria in the blood. Normally the body’s immune system can fight off a localized infection caused by a small amount of bacteria in the blood and the person will remain asymptomatic. However, a hospitalized patient could be immunocompromised, have a

Discuss how the drug dobutamine affects cardiac output. Identify the nursing implications with the administration of this drug.

Aitken, L., Williams, G., Harvey, M., Blot, S., Kleinpell, R., Labeau, S., & ... Ahrens, T. (2011). Nursing considerations to complement the Surviving Sepsis Campaign guidelines. Critical Care Medicine, 39(7), 1800-1818.

My main priority would be to dehydrate the patient with a normal saline IV, then administer drugs for her pain, the dilaudid that the physician ordered for her. Then I would administer 5 ml’s of Vancomycin to treat the C. Diff.

There is a disease continuum with increasing severity if not treated or not responsive to treatment o Sepsis

541). Interventions should be rendered continuously, promptly and appropriately as it can cause life-threatening complications (Holt 2009, p. 26). Apparently, the patient is stable, but continuous assessment and management should be done to avoid recurrences of untoward signs andsymptoms and prevent potential complications. Firstly, continuous assessment and vital signs should be done and these include blood pressure, cardiac rate, respiration, venous distention and skin turgor to assess possible occurrence of fluid overload as a result of rapid administration of large fluid that is often needed to treat the patient with DKA (Smeltzer & Bare 2004 p. 1185). Aside from this, documentation of fluid intake and output should be monitored and documented to assess for circulatory overload and renal function (Holt 2009, p. 61). Significantly, it is integral in the provision of continuous care that nurses reassess the factors that may have contribute or led to DKA, and educate the patient and his family about strategies to prevent its recurrences (Smeltzer & Bare 2004 p. 1186; Lemone, Burke & Bauldoff 2011, p. 551).

Sepsis is a severe complication of an inflammatory response due to various pathogens with the mortality rates ranging anywhere between twenty-five to thirty percent (Epstein, Dantes, Magill, & Fiore, 2016). Sepsis can be precipitated by various infections including some of the most common ones, like urinary tract infections, pneumonia, and cellulitis. An early sepsis recognition is crucial in improving patient outcomes and decreasing mortality rate. Thus, it is very important for a health care provider to start the necessary diagnostics and implementation of fluids, antibiotics, vasopressors and other necessary treatments based on the

The patient will require surgery to repair the hole in the intestines, and subsequently will have a drainage tube, NG tube, and feeding tube. All drains will need to monitored for placement/movement, and drainage. Input and output will be closely monitored and recorded. The patient will remain on NPO, or nothing by mouth, to rest the bowels along with frequent assessments to monitor for infection and bleeding. The nurse will need to monitor for bowel sounds, vital sign changes, temperature changes, pain, abdomen girth, and wound/incision inspections. The following labs will require monitoring: CBC, H&H, albumin, BUN & creatinine, glucose, and ABG’s and lactic acid if sepsis is suspected. Careful and frequent monitoring of labs will alert the nurse if the patient develops sepsis, or hypovolemia due to excessive bleeding (Belinhof, et al., 2012). In addition to vital signs and labs, the nurse will also include patient assessment into consideration before drawing conclusions by means of critical thinking. After the full assessment has been made, the nurse will report any findings to the health care provider that require further investigation or

Some people would get this during the Vietnam War. To treat Sepsis, you have to take multiple medications including antibiotics and vasopressors. The antibiotic will fight against the disease while the vasopressors will help increase your blood pressure.

Patient 1: For DVT, contact physician for surgical or anticoagulant interventions. For Pneumonia, give medication as ordered, maintain fluids, bedrest, monitor temperature, and WBCs. For aspiration, turn patient to side due to decrease LOC and preform tracheal suctioning.

et al., 2008). Sepsis is a frequent cause of admission to intensive care units (ICUs) and it

Education interventions are very significant in the understanding of different stages of sepsis such as septic shock, uncomplicated sepsis, and severe sepsis. The progression of this disease varies from one person to another, and it can occur to some people through the three stages. Therefore, having a clear understanding of all the three phases that sepsis exists can help in the diagnosis of the diseases effectively. Additionally, education will provide an avenue and strategy of providing optimal care to the patient, and that will contribute to managing their condition. Sometimes the patients may not respond to the treatment administered, and as a result, they can develop multiple organ diseases. Hence, education will provide all the required knowledge to understand and know the various dynamic of the diseases and how it progress in a patient.

The priority assessment for sepsis is identifying patients at highest risk for sepsis, although all patients should be monitored for clinical manifestations. Patients at increased risk include those with chronic illnesses, under one year old or older than 85 years old, the immunosuppressed, postoperative patients, and those debilitated or with poor nutrition (Bernstien 2013, pg 25). To identify sepsis early the nurse will need to look for a respiratory rate of >20, heart rate >90, temperature >100.4 or < 96.8*F, and a white blood cell count of >12,000 cells/mm3 or < 4,000 cells/mm3. Assessments after the resuscitation bundle has begun would include respiratory, cardiovascular, integumentary, urinary, and neurological systems, as well as laboratory values. Respiratory would be assessed for rate and oxygen saturation. Central venous pressure, mean arterial pressure, systolic blood pressure, pulse quality and peripheral pulses would be assessed for the cardiovascular system. Skin would be assessed for warmth, color, and whether it is clammy or dry. Skin would also be assessed for petechiae, ecchymosis, or bleeding of mucous membranes to ensure disseminated intravascular coagulation (DIC) has not begun. Urinary output would be monitored to ensure adequate perfusion to the kidneys and for signs of urinary tract infections. Neurological would be assessed for any changes from baseline mental status. The most important