Nursing care of pneumonia patients with sepsis : 2 case studies.

Abstract

     This comparative case study of two patients aimed to examine nursing care for pneumonia patients with sepsis and to develop efficient and standardized care guidelines for this patient population. The study involved two pneumonia patients with sepsis who were admitted to the Medical Ward 1 at Khon Kaen Hospital between May 1 and September 30, 2025. Data collection tools included medical record reviews, patient interviews, and observations. A health assessment utilized the FANCAS assessment framework to establish nursing diagnoses.

     Results: Case study 1 involved a Thai male referred from Khon Kaen Hospital 2, presenting with fever, cough, and dyspnea for 1 hour prior to arrival. He had diabetes mellitus, hypertension, and chronic kidney disease. The physician diagnosed pneumonia with sepsis, and the patient required mechanical ventilation. Nursing care addressed 7 problems: risk of septic shock, tissue hypoxia due to decreased gas exchange area and anemia, sepsis, risk of decreased level of consciousness due to hyperglycemia, fluid and electrolyte imbalance, decreased activity tolerance due to reduced lung function, and patient and family anxiety. The patient experienced no complications, was hospitalized for 4 days, and was discharged by the physician's order. Case study 2 involved a Thai male referred from Nong Rua Hospital with cough and dyspnea for 3 hours before arrival. He had diabetes mellitus, hypertension, and COPD. The physician diagnosed pneumonia with sepsis, and the patient required mechanical ventilation. Nursing care addressed the same 7 problems as in case 1, with a decreased risk of consciousness due to both hypo- and hyperglycemia. The patient experienced no severe complications, was hospitalized for 9 days, and was discharged by the physician's order. Findings demonstrate that using the FANCAS assessment framework enables comprehensive problem identification and holistic care, aligning with the needs of patients and their families.