...Sepsis An Overview Health And Social Care Essay ukessays.com /essays/health-and-social-care/sepsis-an-overview-health-and-social-careessay.php Sepsis is an infection of the bloodstream. The infection tends to spread quickly and often is difficult to recognize. One of our roles as a nurse is that of patient advocate, and as such we are closest to the patient, placing us in a key position to identify any subtle changes at their earliest onset and prevent the spread of severe infection. Knowledge of the signs and symptoms of SIRS, sepsis, and septic shock is key to early recognition. Early recognition allows for appropriate treatment to begin sooner, decreasing the likelihood of septic shock and life-threatening organ failure. Once sepsis is diagnosed, early and aggressive treatment can begin, which greatly reduces mortality rates associated with sepsis. sep•sis (ˈsep-səs) n. Sometimes called blood poisoning, sepsis is the body's often deadly response to infection or injury (Merriam-Webster, 2011) Sepsis is a potentially life-threatening condition caused by the immune system's reaction to an infection; it is the leading cause of death in intensive care units (Mayo Clinic Staff, Mayo Clinic 2010). It is defined by the presence of 2 or more SIRS (systemic inflammatory response syndrome) criteria in the setting of a documented or presumed infection (Rivers, McIntyre, Morro, Rivers, 2005 pg 1054). Chemicals that are released into the blood to fight infection trigger widespread inflammation...
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...Septic Shock Medical Careers Institute NUR 255 November 19, 2014 Instructor Y. Rogers Introduction Septic shock is the most common type of circulatory shock. Sepsis or septic shock is systemic inflammatory response syndrome (SIRS) secondary to a documented infection. This response is a state of acute circulatory failure characterized by persistent arterial hypotension despite adequate fluid resuscitation or by tissue hypoperfusion (manifested by a lactate concentration >4 mg/dL) unexplained by other causes. Sepsis can occur in stages that may progress from uncomplicated sepsis, to severe sepsis, to shock. Despite efforts to decrease shock with the use of antibiotics, the incidences continue. Septic shock is the leading cause of death in noncoronary ICU patients. More than 18 million cases of severe sepsis occur each year, this results in 1,400 deaths worldwide every day (Hinkle, 2014). Background In the past, the terms sepsis and septicemia have referred to several ill-defined clinical conditions present in a patient with bacteremia. These 2 terms have often been used interchangeably; however, only about half of patients with signs and symptoms of sepsis have positive results on blood culture. Serious bacterial infections at any site in the body, with or without bacteremia, are usually associated with important changes in the function of every organ system in the body. These changes are mediated mostly by elements of the host immune system against infection...
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...Improving Outcomes in Sepsis Patients in the Emergency Department Sepsis is a left threatening illness that affects millions of people each year. The Center of Disease Control reports sepsis as the 10th leading cause of death in the United States (V). For adults age 65 and over hospital admission because of sepsis have increased 48%. The body’s immune system switches into “high gear” which overwhelms the body’s normal blood flow and oxygenation of tissues throughout the body. This process, if not treated in time, can quickly lead to organ failure and death. Approximately one third of people diagnosed with sepsis die from it. The role of emergency departments throughout the country has become vitally important to the early detection and treatment of sepsis. With the implementation of sepsis protocols in the emergency department the mortality of patients with sepsis admitted through the ED is significantly lower. The word sepsis is commonly used to diagnose patients, but the debate continues as to the true definition. The word sepsis comes from the Greek meaning decay or to putrefy.” (A). Sepsis is a general term that is applied to patients that develop clinical signs of infection. Unlike other diseases sepsis is not diagnosed by the location or type of microbe involved in the infection. Some of the criteria used to diagnose sepsis are abnormalities of body temperature, pulse, respirations, and white blood cell counts. Some symptoms that are common in septic patients...
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...integration of ever-evolving clinical expertise and external evidence in day-to-day practice. The definitive goal of nursing process in an EBP is to promotes quality, cost-effective outcomes for patients, families, health care providers, and the health care system (Brown, 2009; Craig & Smyth, 2007; Cullum, Ciliska, Haynes, & Marks, 2008). Second to heart attacks, sepsis is the leading cause of death. As many as 750,000 patients progress into severe sepsis each year in U.S. hospitals, and approximately 200,000 of these patients do not survive yet it is preventable. September is Sepsis Awareness Month and September 13th is World Sepsis Day to raise awareness of sepsis in the hope to increase knowledge resulting in fewer preventable sepsis deaths. In treating sepsis, the first hour is very critical and the first 24 is decisive .Sepsis can be extremely difficult to diagnose in the early stage and the aggressive nature of sepsis, diagnosing and initiating treatment of the infection needs to be done as early as possible. I work in a med-surge floor and we are one of the pilot floor of two for implementing sepsis protocol. The medicine service line find...
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...Prevalence, outcome and prognostic factors of sepsis in Jimma Specialized Hospital. By Dr Tadiwos Hailu (M.D) A Proposal Submitted to the Department of Internal Medicine, Jimma University, in Partial Fulfillment of The Requirement for a Specialty Certificate in Internal Medicine. September, 2012 Jimma, Ethiopia Prevalence, outcome and prognostic factors of sepsis in Jimma specialized hospital. Dr Tadiwos Hailu By Advisors: 1-Dr.Daniel yilma [M.D] 2-Birtukan Tsehayneh [Bsc. Msc.] September, 2012 Jimma Ethiopia i Abstract summary Background: Sepsis is a final pathway of infectious disease in critically ill patients. It is highly fatal condition. Though many researches are undertake in pathophysiology, epidemiology and management of sepsis in developed nation ,very limited information is available in low incomes countries where infections are prevalent. Objective: The objective of the study was to determine the prevalence and outcome of sepsis and its prognostic factors in patients admitted to Jimma University Specialized Hospital. Method: Patients with systemic inflammatory response due to infections were studied using prospective cohort study design for four month period in Jimma University hospital. A structured questioner was used to collect data on socio demographic feature of the patient and clinical feature, outcome and prognostic factors . Data was cleaned, edited and entered to SPSS window for analysis. The survival analysis and determination...
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...As stated earlier, sepsis is a worldwide problem. Sepsis strategies/guidelines are imperative to utilize to make a positive outcome. Becker and Dorman share that “sepsis affects more than 1 million patients a year in the United States and even more patients around the globe and is one the leading causes of death,” (2017, para 1 p 807). With these astounding statistics, it is prudent of nursing educators to perform their part in educating the nursing students on life saving strategies against sepsis. Proactive healthcare is one of the ways this author has grown through her discovery as being a leader in healthcare. Prevention to illnesses is preferred than reacting to the severity of illness. Although not all sepsis cases can be prevented,...
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...Over I have several goals regarding my future nursing career; however, my long term nursing goal is to work in critical care. My exposure to this area of nursing occurred when my mother was in the intensive care unit following exploratory surgery due to severe abdominal pain which revealed necrosis of a large portion of her large intestine. Following this, she spent many weeks in the intensive care unit with a diagnosis of septic shock. During her time in the ICU, she was mechanically ventilated for several weeks. In addition, she had evidence of kidney injury and subsequent hyperkalemia that resulted in cardiac irregularities. Her experience as a patient and my experience as the family point person in communicating with the healthcare team and observing the nursing staff played an important role that led to my decision to focus my future nursing career on critical care nursing. I was inspired by the overall knowledge, commitment, and diligence of the night shift nurse who cared for my mother consistently. He was very compassionate with us, extremely knowledgeable in responding to all of our questions about the pathophysiology of her condition, and explaining the rationale of the treatment approach made a positive difference in her outcome. “Critical care nursing is that specialty within nursing that deals specifically with human responses to life-threatening problems. A critical care nurse is a licensed professional nurse who is responsible for ensuring that acutely...
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...I. Introduction - Shock (Chapter 11) A. Review of anatomy and physiology B. Pathophysiology Initiation | * Decreased tissue oxygenation * Decreased intravascular volume * Decreased Myocardial contractility (cardiogenic ) * Obstruction of blood flow (obstructive) * Decreased vascular tone (distributive) * Septic (mediator release) * Neurogenic (suppression of SNS) | No observable clinical indications Decreased CO may be noted with hemodynamic monitoring | Compensatory | * Neural compensation by SNS * Increased HR and Contractiliy * Vasoconstriction * Redistribution of blood flow from nonessential to essential organs * Bronchodilation * Endocrine Compensation (RAAS, ADH, glucocorticoid release) * Renal reabsorption of sodium, chloride, and water * Vasoconstriction * Glycogenolysis | * Increased HR (EXCEPT NEUROGENIC) * Narrowed pulse pressure * Rapid, deep respirations causing respiratory alkalosis * Thirst * Cool,moist skin * Oliguria * Diminished bowel sounds * Restlessness progressing to confsion * Hyperglycemia * Increased specific gravity and decreased creatinine clearance. | Progressive | * Progressive tissue hypoperfusion * Anaerobic metabolism wih lactic acidosis * Failure of sodium potassium pump * Cellular edema | * Dysrhythmias * Decreased BP with narrowed pulse pressure * Tachypnea * Cold, clammy skin * Anuria * Absent bowel sounds * Lethargy progressing...
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...of the essay is to analyse the care of a septic patient. While discussing the relevant physiological changes and the rationale for the treatment the patient received, concentrating on fluid intervention. I recognise there are other elements to the Surviving Sepsis Bundles, however due to word limitation; the focus will be on fluid intervention. The essay will be written as a Case Study format. To maintain patient confidentiality any identifying features have been removed in keeping with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (NMC, 2008) the patient will be referred to as Mr X. Mr X was an 80-year-old male admitted to ITU, from the Medical Assessment Unit, with increasing respiratory failure. His initial clinical observations were: Systolic Blood Pressure: 100mmHg MAP: 58mmHg Heart Rate: 120 beats per minute Lactate: 3.2mmol/l Temperature: 38.6* These clinical observations indicated that the patient was experiencing a systemic inflammatory response syndrome (SIRS) as the patient had a pyrexia above 38*C and a heart rate above 90 beats per minute. The results of the blood cultures and chest radiograph indicated pneumonia. The patient’s condition was now treated as sepsis. Sepsis is characterized by SIRS, which is complicated by a severe infection (Neveire, Parsons and Wilson 2008). The pathophysiology of systemic inflammatory response, experienced by Mr X is portrayed in Table 1: Table 1 Morton et al 2005 Mediator | Source |...
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...Regina is a young woman that was admitted to the ward with a bowel obstruction from a prolonged ileus. She presented with symptoms of nausea and vomiting. She’s recently been suffering from poor nutrition, weight loss and anemia. She also has a long history of Crohns disease. In order to support and nurse Regina the following topics have been investigated to help create a care plan (The acute health issue/s, Aetiology, Pathophysiology, Clinical manifestation (signs & symptoms), Potential complications, Multidisciplinary care (treatment and management), Nursing care and management Regina’s acute health issues include bowel obstruction, nausea and vomiting, anemia and loss of weight. The most common causes for a bowel obstruction are intra-abdominal...
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...NPs who are Master’s prepared are positioned as clinical leaders to drive EBP with bedside nurses through formal education (Gerrish et al., 2011). The ACNP can drive research projects, offer training through the use of in-services, and ensure EBP is carried out at the bedside. For example, the ACNP can develop a clinical practice guideline that would aide in better glucose control or recognizing sepsis on admission. All of these are characteristics of leadership. The ACNP recognizes EBP as a step from making clinical decisions based on customs and practice to basing decisions on scientific evidence, which improves quality of care (Gerrish et al., 2011). Professionalism There are not a simple one size fits all definition to professionalism in the nursing profession. Professionalism can be described as the competence, beliefs, morals, and demeanor shared with those engaging in the practice of medicine (Young, 2010). Professionalism influences evidence-based practice through the way care is perceived and delivered to the patient, thus affecting patient outcomes. Professionalism controls nursing practice through the NPs impression on clinical...
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...Identifying Strategic Issues Cherra T. Hampton-Mitchell Benedictine University Abstract Phase four of the Mobilizing for Action through Planning and Partnerships (MAPP) process provides guidance for identifying strategic issues in the target community (National Association of County & City Health Officials, n.d.). According to the National Association of County & City Health Officials (NACCHO), identifying strategic issues reveals what is important within the community (NACCHO, n.d.). By identifying these issues, strategies can be developed to improve community health (NACCHO, n.d.). The purpose of this research is to identify strategic issues in Petersburg, Virginia. Synthesis and Analysis Four MAPP Assessments were conducted during phase three of the MAPP process. The four assessments include the Community Themes and Strengths Assessment, the Local Public Health System Assessment, the Community Health Status Assessment, and the Forces of Change Assessment (NACCHO, n.d.). Each Assessment revealed important information about community health in Petersburg, Virginia and must be analyzed to give a complete picture (NACCHO, n.d.). The Community Themes and Strengths Assessment (CTSA) revealed several important thing about Petersburg. Petersburg, despite being a small city, has a wealth of healthcare resources within city limits and in the surrounding area. There are two organizations that provide primary...
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...Rhabdomylosis was evident due to the patient’s collapse and muscle wasting (as evidenced by a BMI of 18.5). The death of muscle fibers releases myoglobin and creatinine kinase. The Rhabdomylosis was a contributing factor that caused renal complications. Increased blood urea nitrogen and creatinine levels were apparent. Potassium levels were elevated, which led to cardiac complications. Sepsis was acquired later as evidenced by bradypea, elevated temperature, and a pulse under 90 bpm. Sepsis caused further damage to the heart, lungs, kidneys, and liver. CVVH was then implemented for this unstable patient. Fluid and solutes were eradicated. The CVVH was initiated to help with kidney filtration. CTE was also a possible concern as evidenced by the patient participating in contact sports for several years. Several contusions or injuries to the brain can cause a degenerative brain disease. A heroin overdose and alcohol toxicity provoked the mentioned complications. Opioid overdose is a leading cause of accidental death among adult in the United States. Prescription opioids are believed to serve as a gateway to the use of heroin, which is more accessible and more affordable than prescribed medications. According to Volkow & McLellan’s...
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...Lung Injury* A Review Mark R. Looney, MD; Michael A. Gropper, MD, PhD, FCCP; and Michael A. Matthay, MD, FCCP Transfusion-related acute lung injury (TRALI) is an underreported complication of transfusion therapy, and it is the third most common cause of transfusion-associated death. TRALI is defined as noncardiogenic pulmonary edema temporally related to transfusion therapy. The diagnosis of TRALI relies on excluding other diagnoses such as sepsis, volume overload, and cardiogenic pulmonary edema. Supportive diagnostic evidence includes identifying neutrophil or human leukocyte antigen (HLA) antibodies in the donor or recipient plasma. All plasma-containing blood products have been implicated in TRALI, with the majority of cases linked to whole blood, packed RBCs, platelets, and fresh-frozen plasma. The pathogenesis of TRALI may be explained by a “two-hit” hypothesis, with the first “hit” being a predisposing inflammatory condition commonly present in the operating room or ICU. The second hit may involve the passive transfer of neutrophil or HLA antibodies from the donor or the transfusion of biologically active lipids from older, cellular blood products. Treatment is supportive, with a prognosis substantially better than most causes of clinical acute lung injury. (CHEST 2004; 126:249 –258) Key words: ARDS; lung injury; pulmonary edema; transfusion; transfusion-related acute lung injury Abbreviations: ALI acute lung injury; FDA Food and Drug Administration; Fio2 fraction of...
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...achieved by the Philippines, however, if the neonatal mortality rates are not addressed from its non-moving trend of decline, MDG 4 might not be achieved (http://www.doh.gov.ph/node/2664). Based on health statistics, the Philippines is one of the 42 countries that account for 90% of under-five mortality worldwide. Eighty two thousand (82,000) Filipino children under five years old die every year. Thirty seven percent (37%) or 40,000 of them are newborn. Majority of them (3/4) die within the first two days of life, mostly from preventable causes. The high mortality and morbidity rates in newborn are directly related to inappropriate hospital and community practices currently employed throughout the Philippines. According to the Department of Health (2009) that correct and appropriately-timed interventions given to the newborn during this period will benefit both the newborn and the mother as these will avert approximately 70% of avoidable newborn deaths (Department of Health, 2009). Studies found out that Philippine hospitals’ practices...
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