Nursing Care for Suspected Pulmonary Tuberculosis Patients with Septic Shock and Acute Respiratory Failure at Mukdahan Hospital: Two Case Studies

Abstract

Objective : To examine nursing care for patients with septic shock complicated byacute respiratory failure and suspected pulmonary tuberculosis.
Methods : This study employed a case study design involving two patients admitted to Mukdahan Hospital. The cases were selected purposively and data were collected from inpatient medical records between February 14 and February 28, 2026. Data collection instruments included a structured data recording form. Patient health status was assessed using Gordon’s 11 Functional Health Patterns and the FANCAS framework. Data were analyzed through comparison of pathophysiology, clinical manifestations, medical treatment, nursing problems, nursing diagnoses, nursing interventions, and nursing outcomes.
Results : Case 1 A was a 65-year-old male with a history of pulmonary tuberculosis treated five years previously. He presented with productive cough for one week prior to admission. The patient was diagnosed with pneumonia, septic shock, acute respiratory failure, and suspected pulmonary tuberculosis. He was admitted to a negative-pressure isolation room in the intensive care unit and managed according to the clinical guidelines for patients with suspected pulmonary tuberculosis. Chest radiography revealed left lung infiltration with left pleural effusion. Treatment included endotracheal intubation, antibiotic therapy, vasopressor administration, and supportive care. The patient’s condition improved and he was discharged after 14 days of hospitalization.

Case 2 A 89-year-old male with a history of spinal tuberculosis treated nine years previously and underlying diseases including hypertension and stage 3 chronic kidney disease. He presented with productive cough, dyspnea, and orthopnea for three days prior to admission and was referred from a community hospital with endotracheal intubation. He was diagnosed with pneumonia, septic shock, acute respiratory failure, and suspected pulmonary tuberculosis. The patient was admitted to a negative-pressure isolation room in the intensive care unit and managed according to clinical guidelines for suspected pulmonary tuberculosis. Chest radiography showed right lung infiltration. Treatment included mechanical ventilation, antibiotics, vasopressors, and supportive management. The patient’s condition
improved and he was discharged after 9 days of hospitalization.

Conclusion: Effective nursing care for patients with pneumonia complicated by septic shock and acute respiratory failure with suspected pulmonary tuberculosis can reduce complications and mortality. Early recognition, prompt treatment, continuous monitoring, and evidence-based nursing management play crucial roles in improving patient outcomes.