Nursing Care of the Severe Sepsis and Septic Shock Patients with Acute Respiratory Failure : 2 case studies

Abstract

Purposes : To study and compare nursing care for patients with sepsis according to the FANCAS nursing concept and propose nursing guidelines for patients with severe sepsis and septic shock with acute respiratory failure.

Study design : Retrospective descriptive study, 2 case studies.

Materials and Methods : By reviewing data on patients with severe  sepsis, septic shock and acute respiratory failure in the Intensive Care Unit Two case studies were selected using the FANCAS assessment, data were analyzed using content analysis.

Main findings : Case Study 1: A 62-year-old Thai female patient came to the hospital with symptoms of fever, cough with sputum, which occurred 1 day before coming to the hospital. Upon admission, it was found that she had a fever and low blood pressure. Diagnosed with severe sepsis and septic shock. Have high blood sugar levels, admitted the patient to the in-patients department of medicine ward and had respiratory failure. She was intubated and transferred to the Intensive Care Unit. Case study 2: A 77-year-old Thai female patient also came to the hospital. She was tired, short of breath, and diarrhea 9 hours before admission. The patient had sudden respiratory failure, was intubated. Both patients were in a critical stage and received nursing care according to the FANCAS nursing concept as follows: 1) Fluid balance: There was an electrolyte imbalance. The patient has an irregular heartbeat. There is a high concentration in the blood due to excessive sugar retention in the blood. 2) Aeration: There is a depletion of oxygen in the blood due to sudden respiratory failure. There is an acid-base balance disorder in the body. 3) Nutrition: There is a chance of malnutrition due to changes in eating patterns. 4) Communication: There is anxiety and fear due to the severity of the disease and the uncertainty of the disease's progress. 5) Activities: Decreased personal hygiene due to being less able to help oneself. 6) Stimulation: There is shock from infection. There is a chance of complications from intubation and mechanical ventilation.

Conclusions and recommendations : The FANCAS nursing concept can be applied to care for patients with severe sepsis and septic shock. Who have acute respiratory failure is appropriate, can be used to collect important information that responds to changes in the pathology of patients in critical situations completely.