Emergency nursing care of acute calculous cholecystitis with septic shock : A case study

Abstract

This study aimed to study nursing care of patient with septic shock.: A case study
Result: The 58-year-old man, walked in Kingnarai hospital at emergency room, on August 29
April, 2022. He had stupor, fever, chills and abdominal pain at upper quadrant for one day. Nursing
assessment, body temperature 38.9 degree Celsius, respiratory rate 26 beats per minute, heart rate 116
beats per minute. The complete blood count WBC 13,660 cells/mm3. The diagnosis was sepsis. The
computerized tomography at abdomen found acute calculous cholecystitis. Calculation based on the
SIRS (systemic inflammatory response syndrome). The diagnosis was septic shock. For emergency care,
particularly emergency room immediately. For supporting of circulatory system, Ceftriazone 2 gm
intravenous drip, Levophed 4 mg. in D-5-W 250 ml. (1:62.5) intravenous drip 15 microdrop/min. On
0.9% NSS load 1,000 ml Emergency nursing care of septic shock, giving nursing assessment, nursing diagnosis, nursing implementation and nursing evaluation. The 6 bundle guidelines, increase blood flow
and oxygen transport. Control IV fluid with infusion pump and record urine per hour. The patient
refused urinary catheter but he had adequate urine. Follow up blood pressure 98/58 mmHg. He was
referred to ICU. He was received the surgery Endoscopic retrograde cholangiopancreatography (ERCP),
on August 30 April, 2022. He has been treated and released from the shock quickly. He was admitted
in Hospital for 9 days. He was discharged with continuity of care.