Medical History

Montgomery College School of Nursing- Simulation

Sepsis

James Daniels-

Came to the emergency room with complaints of fatigue, fever and malaise for 1 week. He reports he was alternating Acetaminophen and Ibuprofen every 4-6 hours for the fevers.

Past Medical History:

Pre-hypertension, Raynaud’s syndrome

 

He has not received any medications while in the hospital. He is currently waiting for his ride.

 

When the nurse obtains vital signs, what are your concerns? Does anything jump out at you that the nurse should be paying close attention to?

 

 

 

 

 

 

 

 

 

 

 

What would you say differently to the Nurse Practitioner to get a more positive response?

 

 

 

 

 

 

 

 

 

The CNA comes to the nurse and reports James sat up to void and said he felt like he wants to pass out.

 

The nurse and the Nurse Practitioner immediately go into the room.
What interventions should be performed at this time?  

 

 

 

 

 

 

 

 

 

The Nurse Practitioner order labs:

 

Lactate

CBC

Chem 7

Blood Cultures

ABGs

 

What labs would we want to look at that are specific to infection?

Dehydration?

Acute Kidney Injury?

Sepsis?

Why do we obtain blood cultures? How long does it take to result a blood culture?

Infection?  

 

 

 

 

 

 

Dehydration?

 

 

 

 

 

 

 

 

 

Acute Kidney Injury?  

 

 

 

 

 

 

Sepsis?  

 

 

 

 

 

 

Why do we obtain blood cultures?

 

How long does it take to result a blood culture?

 

 

 

At what point in the patient care does the blood culture need to be obtained?

 

 

 

 

 

 

 

 

 

 

What does a Lactate of 7 mean to this patient?