Nursing care of the patient with septic shock with pneumonia with acute respiratory failure: 2 case studies

Abstract

Background:Septic shock is caused by the body's response to germs or toxins that created by germs, causing
inflammatory processes throughout the body and will result in the malfunction of the body's vital organs.
Until multiple organ system dysfunction (Multiple organ system dysfunction) and cause death in a short time. The most common is a lung infection. The patient develops severe hypoxia leading to acute respiratory
failure.
Objective: To study nursing care guidelines for shock patients from sepsis and pneumonia with acute
respiratory failure two case studies.
Methods: A comparative study of two patients with sepsis-related shock and pneumonia with respiratory
failure who were admitted in Yasothon Hospital from October 2020 to February 2021. Data were collected
from patient medical records and Gordon's 11 health status assessment forms. Comparative data analysis
of pathology, symptoms, symptoms treatment, formulating nursing diagnosis, planning nursing practice and
evaluating nursing outcomes for a total of 3 phases: critical care, continuous care and discharge planning to
back home.
Results: Case Study 1: A 65-year-old Thai male patient with congenital Asthma 3 days before coming to the
hospital. Cough with phlegm is treated at a private clinic. 1 day before, the symptoms did not improve,
breathing more and more tired. The patient was treated by intubation and oxygen with a ventilator that
receiving intravenous fluids and drugs to increase blood pressure called Norepinephrine and antibiotics until
the symptoms improve, the endotracheal tube can be removed. Provide rehabilitation and send back home,
total length of hospital admitted 7 days. Case Study 2: A 66-year-old Thai male patient with congenital
disease DM, HT was taken from a hospital near his home with symptoms, 2 days before coming to the
hospital with fever, shortness of breath and bad bowel movements 3 times during his admission to the
patient community hospital. Having symptoms of drowsiness, shortness of breath. He was intubated and
was transported to Yasothon Hospital. He was treated with oxygen with a ventilator receiving intravenous
fluids and drugs to increase blood pressure Norepinephrine and antibiotics until the symptoms improve, the
endotracheal tube can be removed and provide rehabilitation and send back home, total length of hospital
admitted 10 days.
Conclusion: Evaluation of patients with septic shock and respiratory failure is a critical condition. Providing
effective nursing care will reduce severity and reduce the mortality rate of patients. Therefore, nurses need
to have knowledge on extraordinary skills to assess patients quickly and accurately, including the need to
have a systematic nursing approach continuously from the first reception until the end. This will make the
patient safe and have a good quality of life after discharge