Acute Life Threatening Conditions

This document discusses the pathophysiology, nursing priorities, and management of acute life-threatening conditions, specifically focusing on urinary tract infections and sepsis. It provides insights into the causes, symptoms, and complications of these conditions, as well as the necessary nursing interventions and treatment options. The document also highlights the importance of infection prevention and the role of antimicrobial therapy in mitigating the spread of infections. Additionally, it addresses the impact of these conditions on acid-base balance and the body's compensatory mechanisms. Overall, this document serves as a comprehensive guide for healthcare professionals dealing with acute life-threatening conditions.

Running head: ACUTE LIFE THREATENING CONDITIONS
ACUTE LIFE THREATENING CONDITIONS
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1ACUTE LIFE THREATENING CONDITIONS
Question 1
As evident from the case study, the patient in question, Mr. Kirkman is suffering from
sepsis acquired due to the aggravation of the symptoms associated with a urinary tract infection,
also known as urosepsis. A urinary tract infection, also known as a UTI, is associated with the
acquisition of pathogenic infiltration and the resultant acquisition of detrimental symptoms,
which if left untreated, can result in transmission of infections across the urethra, the urinary
bladder, the ureters and across the entirety of the urinary tract to the kidneys further affecting
renal and excretory functioning (Lee & Kuo, 2017). The acquisition of a urinary tract infection
may be caused due to bacterial or fungal pathogenic microbial strains which easily enter the
urethra due to unhygienic toileting surroundings, inappropriate wiping after urinating or
engagement in unprotected sexual activity (Schaeffer & Nicolle, 2016). This results in
emergence of symptoms such as feelings of irritation and burning during irritation, feelings of
inadequate urination, release of urine which may be highly dark, thick and concentrated and pain
in the lower abdominal area radiating towards the kidney or the right flank – as observed
extensively in Mr. Kirkman who presented for treatment with these symptoms (Hu, Granger &
Jeffery, 2016).
While the body’s natural defense mechanism of immunity attempt to ward off the
impending infectious transmission, lack of timely mitigation and increased rates of immune
functioning associated inflammation may ultimate result in disease proliferation to the kidneys
hence affecting normal renal functioning (Chung, Katz & Love, 2017). It is worthwhile to recall
that the kidneys are key drivers in the excretion of nitrogenous wastes such as urea, creatinine
and maintenance of adequate levels of electrolytes in the serum (Flores-Mireles et al., 2015).

2ACUTE LIFE THREATENING CONDITIONS
Indeed, taking insights from the reports of Mr. Kirkman, the higher than normal serum levels of
sodium, potassium, urea and creatinine in the blood are a clear indication of a loss of normal
renal functioning due to the aggravation and transmission of UTI towards the kidneys.
Disease progression towards an acquisition of sepsis occurs due to increased transmission
of infection via the bloodstream and towards the additional organs of the body. The body
attempts to mitigate the harmful dissemination via increased immune response exertion and
proliferation of T-cell induced inflammatory mechanisms (Peach et al., 2016). However,
alterations in the body’s response towards such defense processes triggers malfunctioning
immune responses, a cascade of pathologies resulting in multiple organ damage and hence,
septic shock. Due to the same, symptoms associated with sepsis emerge and include and altered
state of mental orientation, increased rate of respiration and an alarming drop in blood pressure
to abnormal levels (Dreger et al., 2015). The same can be observed in terms of the symptoms of
deterioration presented by Mr. Kirkman, who at present is unable to engage in normal cognitive
functioning and speech, has a higher than normal rate of respiration, slight increase in body
temperature, an extremely low blood pressure, elevated levels of hypoxia evidence by low partial
pressure of oxygen and flushing of his face.
Question 2
The key nursing priority to be addressed here, as per the Australian Therapeutic
Guidelines is nursing prevention of infection (Kimble, 2016). Taking insights from the
pathologies highlighted above, it must be noted that the primary causative factor underlying the
septic condition of the patient is his urinary tract infection, which has been further caused due to
infection of the urinary tract by pathological strains. It must be remembered that aggravation of

3ACUTE LIFE THREATENING CONDITIONS
pathogenic strains towards other parts of the body from the urinary tract are the primary
underlying causative factor of urosepsis (Wagenlehner, Tandogdu & Johansen, 2017). If left
untreated the pathogenic mechanisms can further aggravate to exert fatal conditions and death.
Hence, prevention of pathogenic microbial strain transmission towards additional organs and
resultant avoidance of multiple organ failure are key rationales underlying the prioritization of
microbial infection prevention and eradication by the nurse (Steffens, Lingenfelter & Sloan,
2018).
Hence, considering the above rationalized care priority the nurse must promptly
administer antimicrobial therapy as per the Australian Therapeutic Guidelines. This will include
collaboratively working with a multidisciplinary workforce as per the Nursing and Midwifery
Board Standards of Practice, which will include the nurse, the allocated clinician and a
nephrologist if needed (Scanlon et al., 2016). Upon discussion, the nurse must immediately
administer antibiotics intravenously such as gentamicin and amoxillin, or penicillin or
cefotaxime. Additionally, the nurse must also ensure that the invasive procedures such as
catheter installation are adequately disinfected and cleaned to prevent further proliferation or re-
infiltration of infections (Ryanto et al., 2019).
Question 3
The results of the arterial blood gases in Mr. Kirkman, indicate poor compensatory
mechanism and a prevalence of acidosis. The normal pH of the body ranges from 7.35 to 7.45. A
drop in rates of pH id detrimental to the body and is associated with the acidosis and resultant
loss of protein, immune and gastrointestinal functioning due to the acidity induced denaturation
of essential enzymatic structure (Ghatak et al., 2016). In situations of acidosis the body attempts

4ACUTE LIFE THREATENING CONDITIONS
to compensate for the harm by increasing inhalation and concentration of pulmonary carbon
dioxide resulting in increased bicarbonate buffers in the blood hence resulting in compensatory
alkalosis. Similarly, the kidneys attempt to compensate for the same by regulating the excretion
of acidic hydrogen ions in the urine. Sepsis due to urinary tract infection results in loss of healthy
renal functioning and the resultant difficulty to release hydrogen ions in the blood. Indeed, the
loss of renal functioning is evident in Mr. Kirkman, as discussed previously in his detrimental
serum urea and electrolyte reports and hence, has resulted in difficulties associated with
hydrogen infection (Mohan & Karunanithi, 2015). Indeed the resultant acidosis is evident in Mr.
Kirkman as observed from his reduced pH as per the normal range. Further, it is worthwhile to
mention that Mr. Kirman has a history of chronic smoking as well as chronic bronchitis – which
are chronic detrimental conditions associated with reduced pulmonary capacity, reduced
inhalation and hence the resultant difficulty in exerting compensation via carbon dioxide
inhalation and saturated. Hence, the same can be observed in Mr. Kirkman’s reduced bicarbonate
and carbon dioxide status as per this blood gas results which indicates a loss of compensatory
mechanisms and hence the increased symptoms of acidosis (Ocakli et al., 2018). It also must be
remembered that such loss in functions is due to the multi organ damage exerted by the sepsis
condition. Additionally it must be noted that the patient’s blood gas reports a high concentration
of lactate in the blood – one of the final buffering mechanisms associated with administration of
a compensatory mechanism. A high rate of lactate in the blood is indicative of low levels of
oxygen in the blood, poor oxygenation and high rates of tissue perfusion. Indeed, this can be
correlated with the patient’s condition of sepsis since the transmission of microbial infection due
to sepsis, is associated with multiple organ and tissue damage and hence, the loss of healthy body
functioning associated with compensation (White et al., 2018). Hence, additional nursing

5ACUTE LIFE THREATENING CONDITIONS
priorities must involve management of acidosis and chronic pulmonary and lifestyle conditions
since the same will result in increased catabolism, protein denaturation, loss of immune
functioning and alterations in mental status as already evident in the patient (Jamshidian et al.,
2018).

6ACUTE LIFE THREATENING CONDITIONS
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