Question

Principles of Antimicrobial Therapy: Appropriate Intervention for Suspected Septicemia (RM Pharm RN 7.0 Chp 43, Active Learning Template - System Disorder)

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System Disorder ACTIVE LEARNING TEMPLATE: STUDENT NAME DISORDER/DISEASE PROCESS REVIEW MODULE CHAPTER Health Promotion and Disease Prevention Alterations in Health (Diagnosis) Pathophysiol ogy Related to Client Problem ASSESSMENT SAFETY CONSIDERATIONS Expected Findings Risk Factors Diagnostic Procedures Laboratory Tests PATIENT-CENTE RED CARE Complications Medications Client Education Nursing Care Therapeutic Procedures Interprofessional Care

Answer 1

Alteration in health( Diagnosis)

Septicemia

A disease caused by the presence of pathogenic organism especially bacteria, or their toxins in the blood stream. It is characterised bychills and fever.

Pathophysiology of Septicemia

Presence of infection in the blood stream is septicemia. The main source of septicemia is a severe infection of any part of the body such as lung infection( pneumonia) , kidney infection etc. Bacteria from the site of infection enters into blood stream and multiplies. Bacterial toxins also released into the blood and circulate all over the body. It leads to systemic inflammatory syndrome( body's protective mechanism mediated by neutrophils, monocytes and chemical substances like prostaglandins, cytokines etc.) and results in fever, chills, increased respiration and pulse and intravascular coagulation. These symptoms leads to impairment in systemic functioning.

Health promotion and disease prevention

There are health promoting measures and preventive methods for Septicemia such as:

1) prevention of infection in children by vaccination

2) Maintain a healthy immune system by adequate nutrion, avoiding bad habits like alcoholism, smoking

3) regularl exercise

4) early treatment for infection

Assessment

Risk factors: Immuno compromised patients ( HIV AIDS, patient undergone transplantation )

Severe ill patients ( burns, accident)

severe infections

very young child and old age people

Expected Findings

Fever and chills

Tachycardia and tachepenia

increased sweating

Changes in Consciousness

Laboratory tests

Blood tests for causative agent and stage of Sepsis

Common bacterias that causes sepsis are E. Coli, Streptococcus pneumoniae, Staph. Aureus etc.

Urine test

wound discharge collection

Diagnostic procedures such as X- ray, scanning( MRI, CT) to Identify the affected organs

Patient Centered care

Medication:

Broad spectrum antibiotics

antipyretic for fever

oxygen supply and IV fluids infusion as supportive therapy

Therapeutic procedures

Wound care/ burn care to drain abscess and proper dressing, procedures for removing any infected tissue or foreign things in the body like intrauterine devìce or catheters.

Nursing care

Administration of medications and fluids as per physician's order

Obtain Blood samples for culture before antibiotics administration

Perform therapeutic procedures( wound dressing) or assist the procedures such as appendectomy.

monitor vital signs and assess urine output

Client education

Take the medications regularly as per order

Attend the follow ups correctly

lifestyle modification such as regular exercise, healthy diet and avoiding smoking and alcohol.

identity the signs of complications of Sepsis ( fever , chills, fainting, confusions)or a new episode .

Interprofessional care

A collaborative approach is essential to improve from septicemia.

Health care team including Physicians, nurses, pharmacist, dietician. Also dialysis staff, Chest physiotherapist, lab technicians and Imaging staff for scanning.

Complications

Sepsis and septic Shock

Sepsis( complex and fatal condition) leads to Septic Shock Syndrome. The main symptoms are changes in Consciousness, confusion, fainting, GI disturbances like diarrhoea, vomiting, dyspnea, oliguria.