Septic Shock. Mr Jedda Merindah, a 33 year old indigenous male has been admitted to hospital post medical emergency call for hypotension. Mr Merindah has currently undergoing chemotherapy for Acute Myeloid Leukemia, he routinely self monitors his temperature and has advised that has not had any high readings recently. On assessment Mr Merindah has a GCS of 15, Heart rate of 118 beats per minute and an ECG reveals atrial fibrillation. This essay will critically detail two signs and symptoms of Mr Merindah’s deteriorating condition using assessment data to support the findings. The clinical assessment data identified will highlight a direct link to the pathophysiology associated with Mr Merindah’s current state of septic shock. A clinical plan of care will be developed including one priority of clinical care and identification of three nursing interventions that will directly address the clinical priority. Contemporary research evidence will be used to further support the clinical priority, nursing interventions, goals and points of evaluation. ‘Rationale’
Signs of Deterioration
Hypotension:
Respiratory Rate:
Clinical Priority Problem
The clinical priority problem for Mr Merindah is inefficient tissue perfusion related to the progression of septic shock as evidenced by a blood pressure of 92/65mmHg, heart rate of 118 beats per minute, capillary refill time of < 3 seconds and cool peripheries.
Nursing Interventions
- Fluid Challenge
- Inotopes
- Fluid Restriction – initiation of fluid balance chart
