Case Study and Multiple Organ Dysfunction
Case Study, Chapter 14, Sock and Multiple Organ Dysfunction Syndrome 1
What predisposed the patient to develop septic shock?
The urinary catheter, combined with substandard medical attention, probably prompted the individual to become septic.
What potential findings would suggest that the patient’s septic shock is worsening from the point of admission?
Deteriorating high blood pressure, excessive sweating, increasing WOB, reduced heartbeats, symptoms of reduced CO, reduced LOC, lowered SaO2, raised lactate levels and also the patient indicated characteristics of apprehension.
The norepinephrine concentration is 16mg in 250ml of normal saline (NS). Explain how the nurse should administer the medication. What nursing implications are related to the usage of vasoactive medication?
The physician can first check the client’s medical documents before monitoring and analyzing vital indicators. Norepinephrine may be administered at a frequency of 2mcg/min and adjusted up to maintain a systolic pressure greater than 100mmHg. Consequences for health care: while the patient is administering norepinephrine, keep a constant eye on him or her. Assess baseline BP and heartbeat before starting treatment, then every 2 minutes from medication beginning till intended range is stabilized, then every 5 minutes during drug delivery. Perfusion should be assessed using I/O. LOC should be monitored.
Explain why the effectiveness of vasoactive medication decreases as the septic shock worsens. What treatment should the nurse anticipate to be obtained to help the patient?
More endotoxins are disseminated through the bloodstream as sepsis intensifies, inflicting injury to the arterial bed. Furthermore, being an older adult will make the client’s predicament worse than if he were youthful. The following therapy would be to deliver 200mg of hydrocortisone per day by the constant stream.
Explain the importance for nutritional support for this patient and which type of nutritional support should be provided?
This patient has indications of illness, and healthy nourishment is essential for recovering and boosting his immunological systems. Enteral nourishment should be given to the patient.
Case Study 2
Describe the pathophysiologic sequence of events seen with hypovolemic shock.
Blood or fluid is lost within the body. The heart’s beating and breathing start to diminish. Blood pressure will begin to fall. The functioning of the tissues will continue to diminish and eventually shut off.
What are the major goals of medical management in this patient?
The objective is to return organ perfusion and oxygenation to normal.
What is the rationale for placing two large-bore IVs?
If the patient requires blood, the two big-bore IVs can be utilized for that, one side for drugs and the other for huge boluses.
What are the advantages of using 0.9% NS in this patient?
When RBCs or other electrolytes do not need to be restored, 0.9 percent NS is employed to raise blood capacity.
What is the rationale for placing the patient in a modified Trendelenburg position?
The reason for modifying Trendelenburg is to raise the BP in a prudent manner.
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