N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide

©2017 Achieve Test Prep Page 74 of 204 1.7 Complications of Infectious Diseases Septic Shock This complication occurs when an overwhelming gram-negative bacterial infection enters the bloodstream and causes complete systemic infection. This is also known as gram-negative bacteremia. The causative organisms are most often pseudomonas aeruginosa, bacteroides fragilis, escherichia coli, neisseria meningitides, and klebsiella-enterobacter-serratia. Once the immune barriers are weakened, the bacteria enter the bloodstream and give off endotoxins that place the body in a state of shock. White blood cells and leukocytes give off protective enzymes that change coagulation and oxygenation of the body. There is blood pooling, decreased cardiac output, and the organs begin to shut down due to lack of oxygen. Depending on the immune system and overall health of the patient, they may be able to fight off the infection with supportive care. If they have weakened immune systems due to other conditions, this complication may be fatal. Signs and symptoms of septic shock: • Confusion • High fever • Chills • Tachypnea • Tachycardia • Warm or cool dry skin with mottling • Cyanosis • Oliguria • Dysuria • Coagulation issues • Hypotension • Increased WBC count on CBC Nursing assessment for septic shock: • Check vital signs: TPR, blood pressure, and oxygen saturations • Check chart for history of recent infection: antibiotic use, wounds, or surgery • Check level of consciousness and mental status • Monitor fluid intake and output of urine • Review laboratory reports: o CBC with differential: Usually the first test run on suspicion of septic shock; antibiotic therapy is usually started based on WBC count beingelevated o Blood cultures X3: Draw blood cultures x3 upon first evidence; treatment is usually not delayed; however, results take 72 hours and patients could deteriorate rapidly o Blood chemistries: Monitors organ response to infection and assists in providing supportive care; IV fluids, electrolytes, and need for dialysis o Wound cultures: Can help to identify causative organism from wounds/surgical incisions

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