Case Study: Shock/SIRS/MODS I have attached the case study along with the questions. If you have any additional questions please ask. Thanks! Case Study: S

Case Study: Shock/SIRS/MODS I have attached the case study along with the questions. If you have any additional questions please ask. Thanks! Case Study: Shock/SIRS/MODS
Adam Smith, 77 years of age, is a male client who was admitted from a nursing
home to the intensive care unit with septic shock secondary to urosepsis. The client
has a Foley catheter in place from the nursing home with cloudy greenish, yellow colored urine with sediments. The nurse removes the catheter after obtaining a urine
culture and replaces it with a condom catheter attached to a drainage bag since the
client has a history of urinary and bowel incontinence. The client is confused,
afebrile, and hypotensive with a blood pressure of 82/44 mm Hg. His respiratory
rate is 28 breaths/min and the pulse oximeter reading is at 88% room air, so the
physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO 2greater
than 90%. The client responded to 2 L of oxygen per nasal cannula with a SaO 2 of
92%. The client has diarrhea. His blood glucose level is elevated at 160 mg/dL. The
white blood count is 15,000 and the C-reactive protein, a marker for inflammation,
is elevated. The client is being treated with broad-spectrum antibiotics and
norepinephrine (Levophed) beginning at 2 mcg/min and titrated to keep systolic
blood pressure greater than 100 mm Hg. A subclavian triple lumen catheter was
inserted and verified by chest x-ray for correct placement. An arterial line was
placed in the right radial artery to closely monitor the client’s blood pressure during
the usage of the vasopressor therapy.
1.) What predisposed the client to develop septic shock?
2.) What potential findings would suggest that the client’s septic shock is worsening
from the point of admission?
3.) Explain why the effectiveness of a vasoactive medication decreases as the septic
shock worsens. What treatment should the nurse anticipate to be obtained to help
the client? What nursing implications are related to the usage of a vasoactive
medication?
4.) Explain the importance for nutritional support for this client and which type of
nutritional support should be provided?

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