Septic Shock: Symptoms, Nursing Interventions and Priority of Care

Running head: SEPTIC SHOCK
SEPTIC SHOCK
Name of the student:
Name of the University:
Author note:

1SEPTIC SHOCK
Introduction:
The purpose of the assignment is to analyze a case study of a deteriorating patient. In this
regards the case of a patient with septic shock has been chosen for the assignment. Septic shock
is occurred due to the result of any infection within a person. It causes significant changes in the
body and leads to the consequence of life-threatening situation and even death as well (Angus et
al., 2015). There are three stages of sepsis or septic shock such as bloodstream infection and
inflammation, severe sepsis that affects the function of brain, lungs, kidney and heart and septic
shock due to significantly low blood pressure that leads to the consequence of heart and
respiratory failure and even death (Asfar et al., 2014). This infection arise when chemicals
released by the immune system to fight infection leak into the blood stream (Garay-Fernández,
2017) .The symptoms include low blood pressure, increased breathing rate and increased
temperature. The increase in temperature is due to stimulation of the thermostat in hypothalamus
while the low blood pressure is due to widened blood vessels when chemicals cause dilation
(Vassiliou, Orfanos, & Kotanidou, 2017). The increased heart rate is due to increased work rate
of the heart. There is also difficulty in breathing due to blood vessels leaking in the lungs.
According to the statistics, 12% of the world population die annually due to sepsis (Kaukonen et
al., 2014). Thus it is important to understand the pathophysiology in order to introduce adequate
treatment to manage the illness.
Case study:
The chosen case study for the assignment is about a indigenous male, Jedda Merinah
aged 33 years. He has been hospitalized in the Hematlogy/Oncology department due to the
emergency call for hypotension by the oncology day unit. To manage his acute myeloid

2SEPTIC SHOCK
leukemia he was receiving chemotherapy in the oncology unit. His health history has indicated
that he has been given chemotherapy for induction phase and reported about nil temperature and
blood culture has shown nil growth. In addition he has suffered from acute rheumatic fever in
childhood, however, no structural abnormalities were found except mild dilation of the left
ventricle. Depression and hypercholesteromia and has tried to attempt suicide as well. On
assessment increase heart rate, respiratory rate, low blood pressure, reduction in food intake due
to mouth ulcer, loose bowel action, reduction in urinary output and high temperature have been
found. Blood test has been done which has indicated lack of Hb and platelets and increase in
creatinine and urea. Center venous catheter line has been inserted by the senior register of ED.
Such situations have led to the deteriorating condition.
Purpose:
The following paper will discuss about the symptoms of deterioration and will provide
effective nursing interventions in order to improve the health condition off the patient in an
effective manner. In this regards the paper will provide one area of priority for clinical care and
introduce three relevant nursing interventions in order to manage the health condition of the
patient and help him to recover faster.
Signs and symptoms of deterioration:
As mentioned in the case study the two major symptoms or reason for the deteriorating
condition of the patient are high temperature that is 38.8 degree Celsius and low blood pressure
such as 92/65 mmHg. According to study high temperature such as 101 degree Fahrenheit or 38
degree Celsius is one of the early sign of septic shock and it should not be ignored (Coopersmith
et al., 2018). Thus, it can be said that such increase in the body temperature is one of the most

3SEPTIC SHOCK
important signs of deterioration in health condition of the patient. On the other hand low blood
pressure is another sign. It has been found that low blood pressure affect the cardiovascular
function in an effective manner. For example, due to low blood pressure less oxygen is able to
reach to the vital organs thus, heart needs to work harder in order to compensate and the heart
rate elevated significantly as found in the patient (Heart rate 118/min) (Lee, 2014). In addition
low blood pressure leads to the leakage of fluid from the blood vessel in the lungs that
accumulates and creates difficulties in breathing, which leads to the increase in the respiratory
rate (Leone et al., 2015). Due to such situation the respiratory rate of the patient elevated to 28
breaths/min. Furthermore, low blood pressure could lead to the consequence of hypovolemia as
well. The significant drop in the blood pressure could lead to shock state as it could cause blood
loss by 30% in individual that could lead to the consequence of hypovolemic shock (Chappell et
al., 2014). Thus, it can be said that such symptoms have contributed to the deteriorating
condition of the patient and need proper treatment to improve the health condition of the patient
in an effective manner.
Priority area of care:
The patient has been assessed with ABCD assessment method which has indicated
increase in heart rate, respiratory rate, low blood pressure and poor fluid intake. The central
venous catheter has been inserted by the senior register in the emergency department. With the
signs of high body temperature, low blood pressure that could cause hypovolemia the insertion
of catheter could lead to the consequence of infection. As found in the blood pathology the
decrease in the Hb and plasma has indicated the lack of blood volume and consequence of
hypovolemic shock. Increase in the creatinine and urea have led to the diagnosis that there is a
high chance that severe infection might have occurred. Such infection could increase the risk of