Case Study for a Patient with Septic Shock

Case Study for a patient with Septic Shock
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Introduction
Septic shock is a condition that comes as result of the inflammatory system responding to
infectious pathogens in the human organism. (Ferrer et al 2008). Septic shock is usually evident
in patients with sepsis, and is considered as a life-threatening condition that is associated with
high mortality rates across the world. The disease is characterized by an excessive inhibitory
response towards pathogens, causing unprecedented changes to the functioning of key organs of
the body, (Bakitas et al 2009). Because of this, cardiovascular dysfunction and respiratory
distress syndrome (ARDS) symptoms are mainly associated with the disease. Related symptoms
and complications of this condition include high fever, hypothermia and rapid heart rate. Severe
septic shock can lead to organ damage, especially the brain, lungs or kidneys, (Inwald,
Tasker,Peters & Nadel 2009). The pathogenesis of this disease can be a bacterial, viral, or fungal
infection. Sepsis can originate from urinary tracts infections or digestive system infections. The
following complications are also noticeable with severe sepsis(Jensen et al 2011):
i. Abnormal urination
ii. Notable confusion
iii. Dizziness
iv. Severe breathing problems
v. Cyanosis
vi. Low blood pressure
vii. Fatigue
Diagnosis of heart failure is often observed in sepsis patients. The relationship between
chronic kidney damage(CKD) and cardiovascular failure is a common phenomenon with sepsis
patients. The patho-physiology between kidney failure and cardiovascular failure is complicated.
Patients characterized with heart failure often have a greater prevalence of heart failure risk
factors, (Qazi & Stoll, B. J. (2009).
The objective of this paper is to analyze the health condition of a case study of a patient
with sepsis, suggest an appropriate treatment plan and nursing interventions for the provided case
study.

Diagnosis of Sepsis
Diagnosis of this conditions requires a subtle clinical approach since sepsis may manifest
itself in myriad ways. The major identifying signs of acute sepsis include micro vascular and
cellular changes which are not easily detected during a clinical examination. The process of
clinical examination for diagnosis of this disease includes activation of coagulation and
inflammatory cascades, vascular realignment, non-optimal utilization of oxygen in the cellular
level,(Inwald, Tasker, Peters& Nadel2009). Additionally, pulse oximetry, monitoring of the
cardiac muscles and blood pressure monitoring are recommended for patients with septic shock.
Rationale of the pathology results
Assessment of the patient shows a neutrophil accumulation of 0.9 %. This is because the
blood stream has been invaded by pathogens, which has led to immense neutrophil
accumulation. The pathogenesis of this condition is majorly brought about by the accumulation
of polymer nuclear (PMNs) on the endothelial cells, which leads to the generation of oxidants
that are rich in cationic nuclear histone which is highly toxic, (Pène et al 2008). Histone may
cause considerable damage to the endothelial cells, which may eventually lead to death. ECG test
shows the heart beat is very high. This is because heart failure condition that is one of the
complications brought about by septic shock.(Zaidi et al 2011). The Glasgow Coma Scale (GCS)
level of the patient is very high. Glasgow Coma Scale (GCS) is a very vital technique of
measuring mental state, and can be a leading factor that may be used in the prediction of sepsis.
The GCS of the patient in the cases study was 15/15, which translates to a SOFA score value of
4. This means that the sepsis of the patient must be very chronic.
Treatment Plan for the patient
Firstly, the patient will require to be retained in hospital admission, as patients with
severe septic shock often require to be hospitalized, (Gaieski et al 2010). Initial treatment would
often include support of the circulatory and respiratory functions. The treatment plan design of
the patient will include the following approaches.