Nursing care of the patient with acute respiratory failure due to septic shock

Abstract

            Background : Septic shock is inflammatory in general body causing from infection or other stimulator that common cause is pneumonia and made high rate of the patient dead from  acute respiratory failure.     

           Case study : A 79-year-old male that was a three days before came to Hospital, he had fever,

cough with secretion, aspirated food and low diet intake. A 4 hours before to Hospital, he was drowsiness and called not wake up. A care giver brought him to Tha Wung Hospital that was intubated with Endotracheal tube by a doctor and opened his vein by 0.9% NSS 1000 cc. ⓥ drip 80 cc./hr., retained Foley’s catheter, Fortum 1 gm ⓥStat then was refer to King Narai Hospital, Lop Buri by his diagnosis was septic shock with acute respiratory failure. After that he was used volume  ventilator with CMV mode and FiO₂ 0.4, TV 500 ml. were set. Early vital signs, his temperature was 38 degrees Celsius, pulse pressure was 100 times/ min, respiratory rate was 32 times/ min, blood pressure was 120/70 mmHg.,  oxygen  saturation 90%. He was hypoxemia, cold extremities, therefore, Nursing care that were used to evaluate hypoxemia, ventilator care, monitor sepsis and respiratory tract obstruction, Fortum 2 gm ⓥ q 8 hrs. , Amikin 500 mg. ⓥ OD X 2 days. Later, Imipenam 500 mg. ⓥ q 6 hrs followed by treatment. Finally, he was improved, ventilator was off  on fifth day and  was moved to medicine inpatient ward. Furthermore, he was discharged by suggestion of discharge planning and followed up within 2 weeks (March 9, 2015). Length of stay (LOS) was 8 days and total cost of care were 58,315 baht.     

            Results : The patient was improved from septic shock with acute respiratory failure.Furthermore, he and care giver had knowledge of disease and self-management for septic shock,acute respiratory failure prevention and readmission.