Nursing care for Patient Necrotizing Fasciitis with septic shock : Case study

Abstract

This study aimed to nursing care of Necrotizing Fasciitis with Septic shock of selective case study in surgical intensive care unit (SICU) at Chaiyaphum hospital since the thirty-first of May to the thirtieth of September 2019.  A male case study were sixty year old; chief complain refered from Kaengkhro hospital because of high fever, severe pain, swollen, red, hot and hematoma of left leg.  Chaiyaphum hospital admitted patient at male surgical ward. Surgical physician were diagnosis of Necrotizing Fasciitis and septic shock; treatments of septic shock; on ventilator because of respiratory rate exacerbate and prepared for debridement of wound at operation room.  After operation, surgical physician were admitted patient at SICU; on ventilator; treatment of septic shock, severe pain, pale and decreased of platelet count.  Patient had could weaning of ventilator in three day, remove from SICU to male surgical ward in fourteen day, Before return to male surgical ward had alert, on oxygen cannula, good of healing wound.

Nursing of problem were 1) septic shock from sepsis 2) risk for hypoxia from decrease of area in exchange oxygen  3) pain from wound left leg  4) risk for shock from hypoglycemia  5) risk for bleeding from abnormal of anticoagulant  6) pale from bleeding and septic shock  7) risk for malnutrition from alteration of nutrition  8) anxiety from illness and lacked of knowledge  for self care.  

After Nursing care; patient were good of clinical, respiration, healing wound and alert.  Surgical physician refer patient come back to Kaengkhro hospital for continuous treatment of antibiotic fourteen day, follow up one and two month at surgical department Chaiyaphum hospital.  Follow up of nursing care were good of healing, red and decrease of size wound, no fever and suggested of patient dressing wound at primary care unit until close wound.