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Nurse Coles

on 6 March 2014

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Transcript of Copy of Copy of Free Cloud Computing glam prezi template

Clinical Presentation

Septic Shock
Joy Coles and Jessica Sorrell
NUR 885
Septic Shock
#1 The Patient:
- 46 year-old female
- 36 kg

#2 The
issue for the day:
#3 Critical Cues
- Tachycardia
o Associated symptom of septic shock
o Indicates that there is a potential
problem with oxygenation
o Indicates fever
o Indicates a fluid problem

One pertinent problem for this patient today was Hypotension r/t severe sepsis AEB BP of 93/44 and 88/39.
- Decreased urine output
o Results from inability to effectively perfuse kidneys
and/or a lack of volume resulting in retention of fluid by kidneys to maintain as much volume as possible
o Indicates severity of perfusion problem
o Indicates possible progression of septic shock to MODS

- Cool skin
o Another indicator of perfusion ability
o Common finding in patients with insufficient volume and
decreased blood pressure and decreased MAP
o Body attempts to perfuse core organs leading to cool skin

#4 The Intervention:
In response to Hypotension
- Constrict the blood vessels
Fill vessel so that vasoconstriction
is successful in an effort to raise BP
#5 Interprofessional roles:

1) Physician
o Vital role in the ability to treat hypotension
o Communication will be ongoing and frequent
o Nurse will need to offer evidence of low blood pressure
and other critical cues
o New orders

2) Pharmacy
o Timely delivery of medications for treatment
o Consult regarding route, dosage, time, and adverse
effects if needed

#6 The Clinical Reasoning:

1) Nutrition - r/t liver failure,
malnutrition and decreased Albumin

2) Iatrogenic - r/t mechanical vent,
arterial and central lines, tube feed
due to increased risk of infection
3) Mobility: limited to hospital bed
and inability to ambulate at this time

4) Psychological: maladaptive coping
mechanisms and strategies
# 7 Patient Education: Infection
o Allow time for patient to stabilize and maintain conscious, alert state
o Begin conversation with a brief explanation of current situation and
what has occurred over the time that the patient has been in the ICU
o Succinct and simple terms regarding infection that was discovered
o Discuss ways to prevent infection, the importance of self-care and avoiding severe complications in the future
 - Prevention
- Hygiene
 - Risk factors
 - Treatment

The patient is a female that was admitted with Septic Shock r/t UTI AEB Tachycardia, Hypotension, Leukocytosis and presence of organism
#8 The Crucial Conversation:
Crucial Conversation:

RN and patient initiate crucial conversation....Can you identify what problems or triggers that exist that contribute to drinking alcohol excessively? Alcohol in excess impedes health and has many negative effects on the body. Self care is vital to maintaining good health. Can you identify some healthy behaviors we have discussed?
- MAP <60
o Most significant indicator of
ability of body to perfuse tissue
o Indicates severity of septic shock
o Indicates need for fluid and/or medications
to assist body in perfusion of tissues
Full transcript