Nursing care of patients with septic shock with vasopressor drug therapy : Two case comparative studies

Abstract

Septic shock caused of toxin made blood vessels to dilate and plasma to leak, less venous return, decrease cardiac out put and decrease blood flow to supply the organs. If the organ lacks of blood supply for a long time. This could cause of multiple organ failure and the most common cause of death. The nurse must be able to quickly assess shock and provide nursing care in accordance to doctor order, administered adequate intravenous fluids, vasoconstrictor drug to raise blood pressure and rush to administered antibiotics to against the germs in time.

Objective: The purpose to study nursing care of the patients with septic shock with vasoconstrictor drug therapy by comparing two case studies.

Methods: The methods were selecting case studies of the patients with septic shock with vasoconstrictor drug therapy, who were admitted for treatment in In-patient department, Namyuen Hospital. The data were collected between April to June 2023. The data analysis accordance with the concept of nursing process and holistic care.

Result: Both women patients were older adults. They were underling disease included diabetes, hypertension and stage 4 chronic kidney disease. The first case was 72 years, presented with abdominal cramps after eating fish larb, at first admission she was no fever, blood pressure 60/40 mmHg, SOS 3 points, H/C showed Bacillus app, administered 0.9%NSS 1,000 ml vein load x II, Levophed (4:100), Metronidazole and Ceftriaxone. She was out of shock within ½ hour, her diabetes was under control, her clinical improved. The doctor discharged her. She stayed in the hospital for 4 days. The second case was 62 years, presented with watery diarrhea and vomiting, swollen and red (Cellulitis) at the feet, at first admission she was high fever, blood pressure 80/50 mmHg, SOS 6 points, H/C no growth, administered 0.9%NSS 500 ml vein load, Levophed (4:250), Metronidazole and Ceftazidime. She was out of shock within 1 hour, her diabetes was under control, cellulitis improved. She was 20% Hct in days 8, administered with PRC 1 unit. After given PRC, she was 27% Hct, her clinical improve respectively. The doctor discharged her. She stayed in the hospital for 11 days.

Conclusion: The key to nursing care for the patient with septic shock was administered adequate intravenous fluids, vasoconstrictor drug to raise blood pressure and rush to administered antibiotics to against the germs in time accordance to the doctor, to help the patient out of shock as quickly as possible to prevent multiple organ failure, which will lead to death. The holistic care used for continuous period, before discharge period should be encouraged the elderly people with chronic diseases to take care themselves properly to prevent sepsis again.