Nursing care of septic shock patient Tham Phannara Hospital Nakhon Si Thammarat Province: Two comparative case studies

Abstract

Sepsis is a life-threatening crisis caused by a severe and persistent inflammatory process in the body. Causes septic shock, leading to multiple organ dysfunction.

The purpose of this study was to comparative study; Disease mechanism, Pathophysiology, Severity of disease and nursing care for patients with sepsis who are in shock. Nursing care of septic patients with shock who are screened at the outpatient department and admitted to the inpatient ward. Tham Phannara Hospital Nakhon Si Thammarat Province

The results of the study found that case study number 1, a Thai man aged 57 years, gave a history that 1 day before coming, he had a fever and pain. Nausea, not vomiting burning sensation when urinating. The patient went for treatment at the clinic and received antibiotics and medicine to treat nausea and vomiting and was sent home, but the symptoms did not subside. 1 hour before coming he had a fever, pain, very tired, so relatives took me to Tham Phannara Hospital. The patient has symptoms of drowsiness and normal vital signs. The doctor admitted him for treatment in the inpatient ward. Diagnosis Pyelonephritis with sepsis give antibiotic drug. Patients with low blood pressure BP 60/40 mmHg. The doctor gave medicine to increase blood pressure. Give fluids intravenous, retained foley catheter. The patient is restless. Urine comes out in the stream, Intubation and refer to Maharat Nakhon Si Thammarat Hospital Admitted to the male medical ward, the endotracheal tube was able to be removed for 1 day and stayed for a total of 5 days, the doctor allowed him to go home

Case study number 2, a Thai man aged 40 years, gave a history that 3 days before coming to the hospital he had fever, chills, pain in the left lower abdomen, normal urination. The patient went to buy medicine to take himself Paracetamol, Brufen, Diclofenac, Ciprofloxacin, Buscopan until 3 Hours before coming to the hospital Had nausea and vomited 4 times, dizziness, no symptoms of diarrhea. After that, relatives took him to Tham Phannara Hospital, The patient has symptoms of drowsiness and slightly low blood pressure, BP 89/60 mmHg. The doctor admitted him for treatment in the inpatient ward, Diagnosis Pyelonephritis with septic shock and gave plasil 10 mg vine stat, antibiotic drug, increase blood pressure drug, intravenous fluids, retained foley^,s catheter. The patient has a pale face, cold sweat, Numbness of the hands and feet, nausea, vomiting, low blood pressure 87/60 mmHg. The doctor increased the dose of blood pressure drug on oxygen canular 3 LPM and refer to Thung Song Hospital for continued treatment. Stayed at Thung Song Hospital for 7 days. The doctor allowed him to go home.

Nursing of septic patients with shock  had symptoms and signs that could change over time and risk the patient's life. Nurses had a duty to monitor, follow up, and evaluate results to cover all dimensions, using Gordon's care model framework to assess the patient's health condition including physical, mental, emotional, social and spiritual aspects according to nursing standards in order for the patient. It is safe and has a good quality of life.