Nursing care for patients with septic shock: a comparative case study of two patients.

Abstract

     This study was a comparative case study of 2 patients with septic shock. The 2 cases had different causes of septic shock. Case 1 was caused by Leptospirosis with septic shock. Case 2 was caused by Pneumonia with ARF with ARDS with sepsis with septic shock. The source of infection had to be eliminated by giving antibiotics. Both cases showed shock since the community hospital. The first case received Fluid Resuscitation and Nor-epinephrine from the community hospital. The second case received Fluid Resuscitation from the community hospital and received Nor-epinephrine at Trang Hospital.
     The results of the study found that both patients were treated by intubation, opening a large vein in the neck (Central line Insertion) to give medicine and fluid, and giving drugs to stimulate blood pressure. In terms of nursing, both patients received Gordon's health assessment. The nursing diagnoses of both patients were different: 1) Body cells did not receive enough oxygen due to reduced gas exchange and ventilation efficiency from lung infection, 2) There was a condition of waste accumulation from kidney failure, 3) There was high blood sugar due to inability to control blood sugar, 4) The patient was at risk of easy bleeding due to low platelets, 5) There was low blood potassium. The problems and needs of each patient and family were resolved until the patient was out of critical stage, the symptoms improved, and they were safe from complications. For the first patient, the doctor allowed him to go home. In 2 weeks, he was scheduled to come back for a follow-up. For the second patient, the doctor sent him back to the community hospital for further treatment to wait for lung recovery.