Question

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?

Answer 1

1.

The patient is experiencing septic shock as she is having urinary tract infection with complications like septicemia .

2. The doctor will order the intervention of

a. Urine culture

b. Fluid maintaince

c. Immidiate IV antibiotics.

d. Complete blood counts because patient is on chemotherapy.

3.

I would like to teach the patient to maintain proper hygienic conditions while handling Catheter,regular changing of catheter, take plenty of fluids to keep the urinary tract healthy .

4.

As the patient is allergic to sulfa and doctor has prescribed Bactrim which is a combination drug and consist sulpha. I would be concerned because the patient is allergic to the prescribed medication and also needs immidiate antibiotic therapy.