Nursing care of a patient peptic ulcer perforated with sepsis: A case study

Abstract

     This study was case study aimed to study the nursing care of a patient peptic ulcer perforated with sepsis. A 48-year-old Thai male patient was admitted to the hospital on February 15, 2023, with symptoms of epigastric pain, abdominal distension, and an inability to lie flat for 1 day before admission. The patient had a history of gout, chronic kidney disease, and liver disease, and had been taking the analgesic Diclofenac.
     Results: A computed tomography scan revealed a ruptured hollow viscus organ. The patient was diagnosed with peptic ulcer perforation complicated by sepsis. Surgery was performed, consisting of exploratory laparotomy with a simple suture and omental graft. Preoperatively, the patient experienced hypoxemia and shock due to dehydration and electrolyte imbalance, in addition to sepsis. Nursing care included administering oxygen, providing adequate fluid resuscitation, administering antibiotics as per the treatment plan, and closely monitoring vital signs. Postoperatively, the patient was at risk of recurrent shock, tissue hypoxia during weaning from mechanical ventilation, and severe pain at the surgical site. Nursing interventions included monitoring vital signs and alleviating pain with Morphine 3 mg IV stat PRN every 4 hours. The patient was successfully weaned from mechanical ventilation 48 hours after surgery and began oral intake on the 4th postoperative day. The patient’s condition improved progressively, and he was discharged home on February 26, 2023, with a total hospital stay of 11 days.