Nursing care for Septic shock at the Emergency Department: Case Study

Abstract

Objective: This case study aims to investigate the nursing care of patients with sepsis shock.

            Methodology: This is a case study of patients with sepsis and septic shock at the Emergency Department of Chaiyaphum Hospital on December 8, 2023. Data were collected from patient histories and relatives, physical examinations, observations, and patient medical records. Data analysis was conducted based on pathology, sign and symptoms, and treatment. Patient assessment uses the Modified Early Warning Score (MEWS) to determine nursing diagnoses, provide nursing care, and evaluate outcomes.

            Result: A 60-year-old Thai female patient with underlying conditions of diabetes, hypertension, and hyperlipidemia presented with abdominal pain, bloating, diarrhea, nausea, vomiting, and fatigue. She was referred from a community hospital and diagnosed with infective diarrhea with sepsis and septic shock. The patient's critical condition was assessed using the MEWS. The nursing problems identified during the critical stage were: 1) decreased peripheral tissue perfusion due to shock; and 2) altered elimination patterns due to gastrointestinal infection. She received nursing care according to the nursing process and treatment according to the Clinical Practice Guidelines for Patients with Sepsis (MHALBIS).

            Conclusion: The patient received treatment according to the Clinical Practice Guidelines for patients with sepsis (MHALBIS) and professional standards. After recovery from the critical stage, the patient's condition was stable. The medical doctor considered continuing treatment in the medical intensive care unit. Following treatment, the patient responded well and was discharged home on December 15, 2023, after
a total of 8 days of care.