Prevention Of Shock

  Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well. She is currently undergoing chemotherapy for bladder cancer. She has an indwelling urinary catheter with scant amount of dark, foul smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50 and RR 28. She is allergic to penicillin and Sulfa. What type of shock is she experiencing? What interventions do you anticipate the doctor will order? What can you teach this patient about prevention of infection? The doctor orders Bactrim. What should you be concern about? Why?    

Sample Solution

   

Type of shock

Based on the patient's presentation, she is experiencing septic shock. Septic shock is a life-threatening condition that occurs when the body's response to an infection damages its own tissues and organs. It is characterized by low blood pressure, rapid heart rate, and rapid breathing.

Interventions

The doctor will likely order the following interventions:

  • Intravenous (IV) fluids: IV fluids will help to increase the patient's blood pressure and improve her circulation.
  • Antibiotics: Antibiotics will be used to treat the infection.

Full Answer Section

   
  • Vasopressors: Vasopressors are medications that raise blood pressure. They may be used if the patient's blood pressure is too low.
  • Intubation: Intubation may be necessary if the patient has difficulty breathing.

Prevention of infection

The patient can be taught the following measures to help prevent infection:

  • Wash hands frequently: Handwashing is the best way to prevent the spread of infection.
  • Avoid contact with sick people: If possible, the patient should avoid contact with people who are sick.
  • Keep her urinary catheter clean: The patient should clean her urinary catheter regularly to prevent infection.
  • Eat a healthy diet: A healthy diet can help to boost the immune system and fight infection.

Concerns about Bactrim

Bactrim is a combination antibiotic that contains sulfamethoxazole and trimethoprim. Since the patient is allergic to sulfa, there is a risk that she will also be allergic to Bactrim.

Additionally, Bactrim can cause other side effects, such as nausea, vomiting, diarrhea, and rash. The patient should be monitored closely for any signs of side effects.

Other considerations

Since the patient is undergoing chemotherapy, she is at increased risk for infection. This is because chemotherapy can suppress the immune system.

The patient's indwelling urinary catheter is also a risk factor for infection. Urinary catheters can provide a pathway for bacteria to enter the bladder and cause infection.

Nursing care

The nurse will play an important role in the patient's care. The nurse will need to:

  • Monitor the patient's vital signs and clinical status closely.
  • Administer IV fluids and antibiotics as ordered.
  • Monitor the patient for any signs of side effects from the antibiotics.
  • Provide supportive care, such as helping the patient to eat and drink.
  • Educate the patient about infection prevention measures.

Conclusion

Septic shock is a serious condition, but it is treatable with prompt intervention. The nurse plays an important role in the care of patients with septic shock.

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