◄ Mail AA 12:05 s-pdx-prod.inscloudgate.net Case Study Shock and Multiple Organ Dysfunction Syndrome 1. A S, is a 77-year-old male patient admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. 2. Patient has Foley catheter in place with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. 3. The patient is confused, afebrile, and hypotensive. BP 82/44 mm Hg. RR 28 breaths/min and the pulse oximeter reading is at 88% room air. Physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. 4. The patient developed diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for inflammation, is elevated. The patient is being treated with broad-spectrum antibiotics and norepinephrine (Levophed) beginning at 2 mcg/min and titrated to keep systolic blood pressure greater than 100 mm Hg. A subclavian triple lumen catheter was inserted and verified by chest x-ray for correct placement. An arterial line was placed in the right radial artery to closely monitor the patient's blood pressure during the usage of the vasopressor therapy. 1. What predisposed the patient to develop septic shock? 2. What potential findings would suggest that the patient's septic shock is worsening from the point of admission? 3. The norepinephrine concentration is 16 mg in 250 mL of normal saline (NS). Explain how the nurse should administer the medication. What nursing implications are related to the usage of a vasoactive medication? 4. Explain why the effectiveness of a vasoactive medication decreases as the septic shock worsens. What treatment should the nurse anticipate to be obtained to help the patient? 5. Explain the importance for nutritional support for this patient and which type of nutritional support should be provided? Answer

◄ Mail AA 12:05 s-pdx-prod.inscloudgate.net Case Study Shock and Multiple Organ Dysfunction Syndrome 1. A S, is a 77-year-old male patient admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. 2. Patient has Foley catheter in place with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. 3. The patient is confused, afebrile, and hypotensive. BP 82/44 mm Hg. RR 28 breaths/min and the pulse oximeter reading is at 88% room air. Physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. 4. The patient developed diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for inflammation, is elevated. The patient is being treated with broad-spectrum antibiotics and norepinephrine (Levophed) beginning at 2 mcg/min and titrated to keep systolic blood pressure greater than 100 mm Hg. A subclavian triple lumen catheter was inserted and verified by chest x-ray for correct placement. An arterial line was placed in the right radial artery to closely monitor the patient's blood pressure during the usage of the vasopressor therapy. 1. What predisposed the patient to develop septic shock? 2. What potential findings would suggest that the patient's septic shock is worsening from the point of admission? 3. The norepinephrine concentration is 16 mg in 250 mL of normal saline (NS). Explain how the nurse should administer the medication. What nursing implications are related to the usage of a vasoactive medication? 4. Explain why the effectiveness of a vasoactive medication decreases as the septic shock worsens. What treatment should the nurse anticipate to be obtained to help the patient? 5. Explain the importance for nutritional support for this patient and which type of nutritional support should be provided? Answer

3-2-1 Code It

6th Edition

ISBN:9781337660549

Author:GREEN

Publisher:GREEN

Chapter19: Insurance And Reimbursement

Section: Chapter Questions

Problem 25MC

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