Pathophysiology and Intervention for Sepsis

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

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Pathophysiology of sepsis:
Sepsis is a severe and debilitation clinical condition occurring due to contamination of
the surgical wound with microbes and initiation of inflammatory process at the site (Gotts and
Matthay 2016). It is mostly common in elderly patients. Local response includes phagocytosis of
the bacteria by macrophages and release off pro-inflammatory cytokines resulting in innate
immune response to the pathogen. It is also triggered by surgical procedures like trauma and if
this process is not balanced by homeostatic anti-inflammatory mechanisms, it has adverse effect
on integrity and repair of tissues nears the wound or surgical site (Mira et al. 2017). Hence, this
pathophysiological mechanism delays wound healing process.
Sepsis is associated with adverse effect on different parts of the body such as blood
pressure, heart rate and respiratory rate. During septic shock, adhrenergic hyporesponsiveness
increase leading to release of vasoactive agenets like nitric oxide. This has affect n the normal
redistribution of blood flow resulting in systemic hypotension and vasoplegia (Kato and Pinsky,
2015). Ventilatory abnormalities like increase in respiratory and heart rate are seen in patients
with sepsis because of increase in energy demand and metabolic demands. This occurs because
of inflammatory response (Prescott et al. 2016). This type of infection is seen in patients after
surgery because of immune-suppression and increase in non-specific inflammatory response
resulting in infection and tissue injury.
Intervention and rationale:
To provide appropriate intervention for sepsis patient Christopher Collins, review of
major problem for him is important. First problem for him is sepsis indicated by red, tight and
shiny skin near the wound site. The second problem for patient was intense pain at the incision

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site. The review of his A-G assessment data revealed low SpO2 values, high heart rate and poor
ABG value indicating risk of poor ventilation for Mr. Collins. Hence, intervention will focus on
addressing these problems for Mr. Christopher Collins. The following are the interventions that
will be implemented for treatment of sepsis:
1. Escalating the senior health professional: The first intervention that needs to be
implemented is to escalate and inform the senior professionals regarding the risk and
symptoms of sepsis. This intervention is relevant with NSW policy on preventing harm to
patient with sepsis as it mentions recognizing signs and symptoms of sepsis and
informing senior clinician as the first step towards sepsis prevention (NSW Government
2014). This intervention is important for Mr. Christopher Collins as the signs and
symptoms of sepsis (redness, swelling and pain), breathlessness, recent surgery and
nausea was found in patient. Hence, informing the senior health professional would help
to initiate treatment as per sepsis resuscitation guideline. Harley et al. (2019) gives
evidence regarding the responsibility of nurse to recognize patients with sepsis and
escalate it to a new medical officer as this ensures appreciation of clinical urgency.
2. Repeat lactate for patient: The sepsis management plan of NSW guideline mentions
monitoring lactate level 4 hours or 8 hours post recognition of sepsis (NSW Government
2014). This strategy is necessary for management of patients with sepsis because of
accumulation of lactic acid due to inadequate oxygenation and increase in by-products
like lactate. Serum lactate monitoring is beneficial in risk stratifying patients with sepsis
and facilitates aggressive early treatment. Regular monitoring of lactate at the bedside
decreases the time to administration of intravenous fluids in patients with sepsis (Rhee et
al. 2018).