Nursing Care for Patients with Septic Shock and Acute Kidney Injury: Two Case Studies

Abstract

     This comparative study of two case studies aimed to provide nursing care for patients with septic shock and acute kidney injury. Data were collected from inpatient medical records. The concept and Gordon’s functional health patterns were applied in patient care. The review of related literature was conducted to find out patients’ problems. The nursing diagnosis was formulated to plan nursing practice and the nursing outcomes were summarized and evaluated.

     The study results were as follows. The first case study was a 62-year-old Thai male having type 2 diabetes mellitus as well as hypertension and CKD stage 3. He came to the hospital with the symptoms of shortness of breath for 8 days, having waist pain and decreased urine output for 2 days. He came for a checkup for diabetes. While waiting to receive the medicine, he felt dizzy without chest pain. He had septic shock and did not activate sepsis protocol from the community hospital, causing hypodynamic state, resulting in acute respiratory failure. He was intubated and put on a ventilator. There was organ dysfunction in 3 systems: the cardiovascular system, the respiratory system and the renal system. He received hemodialysis and was admitted to the Medical Ward, KhonKaen Hospital for 4 days. He was safe and referred back to the community hospital.The second case study was a 77-year-old Thai male having type 2 diabetes mellitus as well as hypertension, hyperlipidemia, old CVA and CKD stage 3. He came to the hospital with the following symptoms: high fever with chills and shortness of breath for 1 day. His body temperature was 39.8 degrees Celsius with Lactate 3.8 mmol/L. He had sepsis and activated sepsis protocol from the community hospital. Acute respiratory failure occurred. He was intubated and put on a ventilator. There was organ dysfunction in two systems: the respiratory system and the renal system. He was admitted to the Medical Ward, Khon Kaen Hospital for 4 days. He was safe and referred back to the community hospital.