Nursing Care of Pneumonia Patients with Septic Shock: Two Case Studies

Abstract

This study The objective was to study nursing care in patients with pneumonia with sepsis shock. Two patient case studies were conducted as case studies of pneumonia patients with sepsis shock. Two patients were admitted to Huai Thap Tan Hospital, Sisaket Province, between April 1, 2023, and September 30, 2023. Data were collected using the Patient Health Status Assessment based on the conceptual framework of Marjorie Gordon's 11 Health Status Assessments. Symptoms, signs, and treatment Assess nursing problems. Prescribe nursing rulings. Plan nursing practice and evaluate nursing outcomes.

Finding: The 1st patient, a 43-year-old female, came to the hospital with symptoms of fever, chill, and difficulty breathing. Prior to coming to the hospital, the patient reported that both feet were swollen without pain or redness for one day. The patient did not receive any prior treatment. One hour before arriving, she experienced fatigue, shortness of breath, and discomfort breathing. The patient initially presented with critical-condition emergency symptoms. The diagnosis indicated pneumonia with septic shock. The patient received care following the guidelines for managing shock due to septic shock. The patient was administered ceftriaxone antibiotics and received intravenous fluids. Additionally, the patient was given norepinephrine to stimulate blood pressure and hydrocortisone through the intravenous route. During the treatment, the patient developed a red rash and itching, prompting the administration of 0.5 ml of adrenaline in the anterolateral thigh and chlorpheniramine through the intravenous route. The patient was found to have hypokalemia, which was treated effectively. During the treatment, it was discovered that the patient had Right pleural effusion and signs of Fluid overload. Diuretics were administered alongside blood pressure management to maintain normal levels. With these treatments, the patient's condition improved, moving out of critical condition. After receiving the necessary medical care, plan for discharge and return home after a five-day hospital stay.

The 2nd patient, a 60-year-old female with a history of pulmonary tuberculosis spanning 5 years, Three days before coming, the individual experienced a fever, cough, fatigue, and dizziness. He had a history of chronic alcohol drinking and was unable to go for treatment anywhere before arriving at the hospital. The medical diagnosis revealed septic shock and left-lower lung pneumonia. The patient received intensive care with intravenous fluids and was initially treated with the antibiotic Ceftriaxone for three days before a switch to Ceftazidime. The patient had an occurrence of hypokalemia. The condition of hypokalemia has been treated to bring the potassium levels back to normal ranges. The patient was treated with thiamine administered intravenous for 3 days. Norepinephrine was administered to stimulate blood pressure, and the patient received bronchodilator medication. Showing signs of improvement, After receiving necessary medical care, plan for discharge, and could return home after a total treatment period of 11 days.

In conclusion, quick access to services for patients with pneumonia and timely care make it possible to get through the crisis and not suffer from respiratory failure. timely care for the treatment of patients with pneumonia and septic shock; Providing effective monitoring of changes It will help reduce the severity of various conditions that occur and complications during care. It helps address violence and crises. Therefore, nurses play a critical role in needing special knowledge and skills in nursing practice, from reception to discharge.