Case Study on Urosepsis

Running head: CASE STUDY ON UROSEPSIS 1
Case study on urosepsis
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A CASE STUDY ON UROSEPSIS 2
In one of the case studies, Mr. .Kirkham, a 75 year old male presented at the emergency
department. He complained of burning sensation while urinating as well as lower abdominal
pains that was radiating into the right flank. Later on, the patient was admitted to the ward after
being diagnosed with Urinary tract infection. NaCL and Sulfamethoxazole trimethoprim were
then administered IV. An indwelling catheter was inserted as well. Diagnosis indicated abnormal
levels of arterial blood gases and 24 hours, he was diagnosed with Urinary tract infection with
sepsis. Urinary tract infections are common infections affecting majority of the population.
Often, the condition is treated quickly with antibiotics. However, among people who do not
experience burning sensation below the waist or those who can’t speak for themselves, there is
delayed treatment of the UTI which later spread to the kidneys .This leads to more pain and
illness. Eventually, urosepsis occurs. Severe sepsis then develops to septic shock. Since Sepsis
and septic shock leads to death, it is imperative to comprehend the pathophysiology, diagnosis
and management of the condition. In the subsequent sections, there will be answers to the case
study of Mr. Kirkmann.
Question 1. Pathogenesis of Urinary Tract Infection with sepsis
Sepsis is a condition brought about as the immune system respond to an underlying
condition. This can be a urinary tract infection like in the case of Mr. Kirkmann. A urinary tract
infection according to the World Health Organization, is any condition that affect the urinary
system from kidneys, ureters, bladder and the urethra. In most cases, urinary tract infections are
as a result of bacterial infections. The body is generally designed in a manner that makes it
difficult to get bacterial UTI. However, in extreme conditions, bacteria from the genital area can
access the urethra or urinary tract through wiping after visiting the bathroom or sexual activity
(Dreger, Degener, Ahmad-Nejad, Wöbker, & Roth, 2015). Furthermore, bacteria can get access

A CASE STUDY ON UROSEPSIS 3
to the urinary system under unsanitary conditions like insertion of catheters like in the case of
Mr. Kirkmann. The UTI is then exhibited through signs and symptoms like burning sensation
during urination and lower abdominal pain radiating into the right flank. In most cases,
underlying UTIs can be effectively treated by antibiotics. If they are not treated well, it might
lead to a serious condition known as sepsis.
Studies show that gram negative bacteria responsible of Urinary Tract infections, have
endotoxins in their cell walls. A good example of the endotoxin is lipopolysaccharide. These
lipopolysaccharides activate the inflammatory, coagulation and complement systems. These
collectively stimulate production of monocytes, macrophages, neutrophils and dendritic cells
(Ghatak, 2016). Finally, the monocytes activate secretion of interlukin-1 and the tumor necrosis
factor alpha that eventually mediate sepsis that is characterized by signs and symptoms such as
fever, low blood pressure, increased heart rate and respiratory rate like it was seen in the case of
Mr. Kirkmann.
Question 2: An appropriate Nursing strategy
Fluid therapy is the best nursing strategy. The rationale of this intervention is to
resuscitate the patient. Studies recommend fluid therapy by using crystalloids like isotonic
sodium chloride or the lactated Ringers solution (Peach, Garvan, Garvan, & Cimiotti, 2016)..
However, it is recommended that it should be used in combination with other methods since fluid
therapy alone cannot repair central venous or wedge pressure.
Question 3: Analysis of arterial blood gases
According to the World Health Organization, an arterial blood gas is a blood test that
seeks to estimate the acidity, PH as well as the levels of oxygen, carbon dioxide from the