Symptoms And Symptoms Of Acute Kidney Infection

African- American female, 71 years old, has been admitted to the hospital from her primary care provider ten days post-op following a right below the knee amputation. Her only complaint is that of abdmonial pain. Her vitals are as follows: BP 100/70, HR 122, RR 22, Temp 101.1, and oxygen level 96% on room air. Glucose level is 563mg/dl on glucometer and the patient states that she takes a round white pill for her diabetes. She has also been diagnosed with hypertension in the past and takes a white oval pill for it. Head to toe assessment that has been completed noted a foul smell omiting from the bandage where the leg has been amputated. Clearly this patient is exhibiting clinical signs of sepsis. The initial thought is that the source of infection is the surgical wound since the foul odor is present. The next few hours are critical in initating treatment for sepsis. Multi-organ failure can result if treatment is not received in

Over the period of admission Mr Smith was observed to have loss of appetite which can have a direct impact on his glucose levels as he is diabetic and generally impact the rate of recovery from the infection as nutrients such as Protein is needed to maintain the individual’s health (Snooks, 2009). Furthermore, malnutrition can put an elderly patient at higher risk of Pneumonia. Similarly, the patient may not feel like drinking fluids and this can put them at risk of becoming dehydrated, which can lead to fatigue (BMJ, 2016). An intake of sufficient liquids can promote the lungs to keep the secretions thin and easy to cough up. Also, sufficient fluid uptake can prevent constipation (NHS Oxleas, 2017). Mr smith was put on a fluid and diet chart to help encourage and monitor his intake.

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

The number of documented cases has been rising every year. “This may be due to the aging population, the increased longevity of people with chronic disease, the spread of antibiotic-resistant organisms, an upsurge in invasive procedures and broader use of immunosuppressive and chemotherapeutic agents” (National Institute of General Medical Sciences, 2014). The mortality rate for sepsis ranges from about thirty percent for patients with sepsis to fifty percent in patients who develop septic shock. Mortality rate varies as to how many organs have been affected. Twenty percent mortality for one organ failure, forty percent for two organs failing, sixty-five to seventy percent for three failed organs, and seventy-five to eighty-five percent when four or more organs have failed. The cost related to sepsis is about seventeen billion dollars per year (about twenty-two thousand dollars per patient), which is six times greater than the cost of patients without sepsis.

Sepsis remains one of the most deadly diseases in the country. According to the literature, a majority of sepsis cases filter though the Emergency department. The diagnosis and treatment of sepsis are complex and the barriers to improving these things are even more intricate but the fact remains that improvement of sepsis care begins in the ED. Early recognition of sepsis using the SIRS criteria followed by multidisciplinary rapid response diagnostic testing and treatment are the keys to improvement of sepsis care in the ED.

The patient is positive for C. Diff, this is causing her to have diarrhea. The diarrhea is causing the patient to be dehydrated because she isn’t retaining any water. This is causing her kidneys to not function properly.

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

Along with factors such as the increasing age of the population and better recognition of the disease (5), the definition of sepsis has recently changed (6), which makes it difficult to both quantify the incidence and interpret

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 exact definitions, stratification, and approach to diagnosis of the sepsis spectrum has been a persistent, yet seemingly productive, endeavor for many years1,5,16. Multiple consortiums have addressed the approach to diagnosing sepsis. In 1992, a consortium, comprised of the American College of Chest Physicians and the Society of Critical Care Medicine, instituted the Systemic Inflammatory Response Syndrome (SIRS) criteria which established the fundamental screening tool for identifying individuals with an inflammatory immune response (Table 1)5. A patient exhibiting two or more of the SIRS criteria combined with the presence or suspicion of infection was the fundamental criteria for sepsis diagnosis5. Although this approach is of merit, it is too broad. Patients recovering from surgery or suffering from various non-infectious processes would meet the criteria for sepsis under SIRS17,18. An exhaustive list of exogenous and endogenous processes may generate a SIRS-inclusive response in the absence of infection18. A criteria with greater specificity was greatly needed.

According to the National Institute of General Medical Sciences severe sepsis strikes about 750,000 people in the United States each year and kills an estimated 28 to 50 percent of those individuals. The most vulnerable populations for sepsis are the elderly and newborns. After completing the whole eleven segments, I learned that anyone with an infection may be at risk for developing sepsis. The whole scenario helped me how to screen for sepsis and how important is to recognize and respond appropriately to early signs of sepsis in hospitalized patients. Once sepsis is diagnosed, early and aggressive treatment can begin which greatly reduces mortality rates associated with sepsis. After completing the whole scenario I learned how to approach

Sepsis is a condition of growing concern for nursing professionals, as the mortality rate has increased each year since its initial documentation in the early 1990s (Levy et al., 2012). Sepsis was first defined in 1991 as a systemic inflammatory response syndrome (SIRS). Since this time, improvements have been made in developing a worldwide definition of sepsis (Levy et al., 2012). Specifically, sepsis is considered to be a life-threatening dysfunction of the organs that results from the dysregulation of a host response to an infectious agent (American Association of Critical-Care Nurses, AACN, 2018).

Assessment Although a patient in severe sepsis may be transferred to the intensive care unit (ICU), medical-surgical nurses must be able to recognize early signs and symptoms of sepsis to ensure prompt treatment before the patient requires ICU admission. Severe sepsis Severe sepsis occurs when a patient with documented sepsis goes on to develop acute organ dysfunction with hypoperfusion and tissue hypoxemia. Simple prevention strategies Without proper assessment and early identification, patients with sepsis can deteriorate quickly, suffering compromised tissue oxygenation and organ dysfunction for many hours. Be aware that although blood pressure readings are crucial in assessing and planning care for the septic patient, mean arterial pressure

Septic shock, a potentially lethal drop in blood pressure due to infection, is not completely understood even with the progress made in science and medicine throughout the years (Heuther & McCance, 2012). It is one of the most common causes of death in the intensive care unit (ICUs) in the United States of America each year, with a mortality rate of 28 to 60 percent (Heuther & McCance, 2012, p. 632). Septic shock is most commonly caused by bacteria, often gram-positive bacteria, acquired while in the hospital, and those who have conditions that reduce their ability to fight infection are most at risk (Young, 2008). This at risk population includes newborns, those over 35 years old, those with diabetes or cirrhosis,

Sepsis will be defined as SIRS with positive microbiological cultures whether respiratory, blood, or urine. Participants in the suspected sepsis group are those who meet SIRS criteria but have negative microbiological findings but have positive screening results such as elevated lactate, glycemic instability, thrombocytopenia, or abnormal radiological findings such as consolidation on chest x-ray, patchy infiltrates, etc. Finally, septic shock will be defined as sepsis with hemodynamic instability as evidenced by persistent hypotension despite fluid resuscitation measures and the need for inotropic or vasoactive infusions (Asadi,