Question

Mr. Raymundo Gonzales, an 84 year old Hispanic male is admitted to your unit with a diagnosis of “Sepsis, origin Unknown.” You document your assessment findings which include the following.

1. Patient is confused, disoriented & restless
2. T-98.9, P-98, R-28, B/P 90/58, Pulse Ox 92%, unable to determine a pain level but grunted & moaned upon abdominal palpation
3. Abdomen firm and rigid
4. Skin warm and dry with scaly patches
5. He urinated 50 ml of cola colored urine
6. He has bilateral crackles at the bases & his breathing is labored
7. No evidence of pressure ulcers

Answer the following questions:

1. Based on the minimal information you have what might you consider being the cause of this sepsis? & why?

2. What orders might you anticipate to carry out to care for this patient?

3. Would you feel comfortable caring for this individual on your unit? If not what unit do you think this patient should be on and why?

Answer 1

In the present scenario, Mr. Raymundo Gonzales, an 84-year-old Hispanic male is admitted to your unit with a diagnosis of “Sepsis, origin Unknown.” The assessment findings are:

1. The patient is confused, disoriented & restless
2. T-98.9, P-98, R-28, B/P 90/58, Pulse Ox 92%, unable to determine a pain level but grunted & moaned upon abdominal palpation
3. Abdomen firm and rigid
4. Skin warm and dry with scaly patches
5. He urinated 50 ml of cola colored urine
6. He has bilateral crackles at the bases & his breathing is labored
7. No evidence of pressure ulcers

1. Based on the minimal information you have what might you consider being the cause of this sepsis? & why?

In my view, I think that the patient is elderly, the reason may be the elderly to get septicemia why because as the age advances for them we can see a compromised immune system. They are vulnerable and more prone to get the infection. Maybe the origin of sepsis is an untreated Urinary tract infection

2 What orders might you anticipate to carry out to care for this patient?

If we are not initiating proper treatment for Sepsis it can progress to septic shock when certain changes in the circulatory system, the body's cells and how the body uses energy become more abnormal. Septic shock is more likely to cause death than sepsis is.

• The need for medication to maintain blood pressure greater than or equal to 65 millimeters of mercury (mm Hg).
• High levels of lactic acid in the blood (serum lactate) after have received an adequate fluid replacement. Having too much lactic acid in your blood means that cells aren't using oxygen properly and results in labored breathing
• Stat Oxygen therapy as soon as possible as directed by a physician.
• Stat adequate amount of IV fluid to main the fluid status and improve the output ratio, to adequately clear out the urine

3. Would you feel comfortable caring for this individual on your unit? If not what unit do you think this patient should be on and why?

I am not comfortable in caring this case in my unit, why because, Sepsis ranges from less to more severe. As sepsis worsens, blood flow to vital organs, such as your brain, heart, and kidneys, becomes impaired. and need frequent monitoring of even minute changes and as well, as he may need continuous oxygen therapy to improve his condition and also need frequent monitoring of all the vital signs and ABG values.

The better he has to get the treatment from an intensive care unit with all the monitoring equipment