Nursing Case Study Assessment on Severe Sepsis with Pneumococcal Presentation

RUNNING HEAD; NURSING CASE STUDY ASSESSMENT
UNIVERSITY:
NAME :
ASSIGNMENT

Nursing Case study 2
Introduction
The case study review analyses Patient Farouq, 75 years old admitted and diagnosed
with severe sepsis with Pneumococcal presentation. He has been administered on IV solution,
antibiotics management and pain reliever drugs. He has presented shortness of breath and
difficulty in breathing on 24 hours post admission. X-ray scan has revealed pneumonia on the
lower lobe. The patient is smoking 2 packs per day; also he has portrayed chronic bronchitis
with current medication being on ventolin and Atrovent.
Pathogenesis of the condition
Sepsis is termed as a life threatening condition which causes organ dysfunction linked
to dys-regulation of the host responses, infections and septic shocks. It is profound in
circulatory, cellular and metabolic abnormalities with higher risks of mortality among
casualties, (Singer et al, 2016).
Sepsis occurrence globally is common problem with an estimate of 270 ( 95% CI176-
412) cases per 100,000 persons. Incidence associated with mortality is often high. With
conditions such as pneumonia leads to an acute infection to the lungs similar to the case study
patient, (Fleischmann et al, 2016).
Sepsis occurs as a septic shock which results from an infection in the body caused by
various infections like pneumonia. Pneumonia condition can be communal acquired,
indicating that any person can acquire in the community setting outside hospital environment.
At times it can also be caused by health care associated infections which statistics estimate to
be associated to contraction by different persons in the treatment processes, (Shankar et al,
2016).
Severe sepsis and septic shock often result in infections anywhere in the body system.
The statistics indicate that one third of those suffering from sepsis die, while the survivors are
left nursing life threatening conditions such as post traumatic stress disorder, fatigue,
dysfunction of the organ, organ amputations and chronic pain, (Fleischmann et al, 2016).
Prevalent source of sepsis infection is pneumonia, it is an infection located in the lungs.
Occasionally it can affect both lungs, however in the case study; left lobe of lungs is affected.
Indicative symptoms are fever, phlegm cough, shortness of breath, muscle pain, fatigue, chest
pain, shaking pills and even sweating, (Churpek et al, 2015).
Globally, pneumonia affects approximately 400,000 people, with it being the leading
cause of infection. Patients having poor prognosis like in the case study can end up
developing sepsis, leading to life threatening state, with the progression of the sepsis severity,
(Stevenson et al, 2014).

Nursing Case study 3
Persons at risk of developing pneumonia sepsis include the elderly, people with history
of cold or influenza, smokers, respiratory diseases patients, toxins exposure. The symptoms
highlighted above depict those of the case study patient. The patient is smoking an average of
2 packets per day and has chronic bronchitis illustrating a condition prevalent which
predisposes him further for pneumonia sepsis infection.
Predisposing factors to the patient is the presence of lung disease in this case, chronic
bronchitis and smoking habit. There are dramatic structural changes which support the
inflammation of the lungs which supports the severe sepsis condition. Further old age is a
factor for the patient. Older persons have greater risks of high burden of sepsis which gives
the patient worst outcomes such as the care given of oxygen support care, (Kaukonen et al,
2014).
Old age sate for the patient is characterised by lowered levels of immunity referred to
immunosenescence, which is a life threatening and affects how the immune system function
and targets any occurring inflammation. The functioning of neutrophil for the patient has
declined due to age and smoking factors which makes the functioning ability not to reach the
source of infection in the lungs and clear the sepsis infection. This deterioration is further
lowered with chronic bronchitis and the occurrence of pneumonia during the sepsis
emergence leading to immunopheresis, leading to failure of neutrophils to combat severe
sepsis infection, (Prescott et al, 2014).
Medication protocols for sepsis management falls under two categories; bacterial and
viral infections. Bacterial infection is often treated with antibiotics management. The patient
in the case study is already on chronic bronchitis medication now coupled with
pneumococcal sepsis the patient has to undergo further strong medication to treat the
pneumococcal sepsis infection. In viral infection, not much treatment is recommended,
however patient shaving this kind of sepsis are often advised to take rest and fluid rich diet in
order to maintain hydration status, (Aalen et al, 2014).
Nursing priority in severe sepsis with Pneumonia
Nursing priority for the patient is geared to address lessening the immune response,
prevention of cellular death, resolving infection, decrease in cellular oxygen with deprivation
and build up of lactic acid and ensuring there is maximum cardiac output for the patient.
A high nursing priority for the nurse is to ensure that patient is stabilized so as to
respond to treatment. In the case study a high nursing priority entails;
- Reducing pain and reducing breathing difficulty for the patient.