Airway Management in Patients with Septic Shock
Nursing Care Plan for Septic Shock
Sepsis is a condition when microorganisms invade the body and cause a systemic inflammatory response. The response generated often leads to a decrease in organ perfusion and organ dysfunction. If accompanied by hypotension it is called septic shock. (Linda D.U, 2006)
Microorganisms that cause septic shock is a gram-negative bacteria. When microorganisms invade body tissues, the patient will show an immune response. This immune response activation evoke various chemical mediators which have various effects that lead to shock, which increased capillary permeability, which leads to leakage of fluid from the capillaries and vasodilatation.
Gram-negative bacteria causing systemic infection that resulted in cardiovascular collapse. Endotoxin gram-negative bacilli causing capillary vasodilation and peripheral arteriovenous bypass open relationship. In addition, there is increased capillary permeability. Increased capacity due to vasodilation of peripheral vascular causes relative hypovolemia, while the increase in capillary permeability causing interstitial to the intravascular fluid loss is seen as edema.
Early signs of septic shock is often a decrease in mental alertness and confusion, which occurs within 24 hours or more before the blood pressure down. This phenomenon is caused by reduced blood flow to the brain.
Outpouring of blood from the heart is increased, but the blood vessels widen so blood pressure drops. Breathing becomes fast, so that the lungs secrete excessive levels of carbon dioxide in the blood decreases.
Early symptoms include shivering, body temperature rises very fast, warm and reddish skin, weak pulse and blood pressure fluctuated. Decreased urine production despite increased flow of blood from the heart. In later stages, the body temperature often drops to below normal.
When the shock worsens, several organs fail:
Airway Management in Patients with Septic Shock
Ineffective breathing pattern related to imbalance between supply and demand of oxygen, pulmonary edema.
Goals and outcomes (NOC)
After the act of nursing, the patient will be:
Sepsis is a condition when microorganisms invade the body and cause a systemic inflammatory response. The response generated often leads to a decrease in organ perfusion and organ dysfunction. If accompanied by hypotension it is called septic shock. (Linda D.U, 2006)
Gram-negative bacteria causing systemic infection that resulted in cardiovascular collapse. Endotoxin gram-negative bacilli causing capillary vasodilation and peripheral arteriovenous bypass open relationship. In addition, there is increased capillary permeability. Increased capacity due to vasodilation of peripheral vascular causes relative hypovolemia, while the increase in capillary permeability causing interstitial to the intravascular fluid loss is seen as edema.
Early signs of septic shock is often a decrease in mental alertness and confusion, which occurs within 24 hours or more before the blood pressure down. This phenomenon is caused by reduced blood flow to the brain.
Outpouring of blood from the heart is increased, but the blood vessels widen so blood pressure drops. Breathing becomes fast, so that the lungs secrete excessive levels of carbon dioxide in the blood decreases.
Early symptoms include shivering, body temperature rises very fast, warm and reddish skin, weak pulse and blood pressure fluctuated. Decreased urine production despite increased flow of blood from the heart. In later stages, the body temperature often drops to below normal.
When the shock worsens, several organs fail:
- Kidneys: urine production decreases
- Lungs: respiratory disorders and decreased levels of oxygen in the blood
- Heart: fluid retention and swelling. May develop blood clots in the blood vessels.
Airway Management in Patients with Septic Shock
Ineffective breathing pattern related to imbalance between supply and demand of oxygen, pulmonary edema.
Goals and outcomes (NOC)
After the act of nursing, the patient will be:
- Vital signs within normal ranges.
- Indicates that a patent airway.
- Demonstrating a clean breath sounds, no cyanosis and dyspnea.
- Open the airway.
- Position the patient to maximize ventilation (Fowler / semifowler).
- Auscultation of breath sounds, record the additional sound.
- Identification of patients need artificial airway installation tool.
- Monitor respiration and oxygenation status.
- Monitor vital signs.
