Treatment
and Nursing Interventions
The treatment of sepsis is extensive and based on causative factors and patient responses, which can vary widely. The treatment begins with treating the underlying cause. Next, the focus is on maximizing oxygen delivery and maintaining adequate cardiac output. Another part of treatment is supporting organ dysfunction. In addition, psychological and nutritional support must be considered (Chulay & Burns, 2006).
The first step in treating sepsis is to determine the underlying cause. In order to do so, one must start by assessing the patient. A complete physical assessment involving checking the ABC’s (airway, breathing, circulation), level of consciousness, skin condition, and a head to toe physical exam will give many clues as to the cause of the sepsis (Filbin 2008). In order to further define the cause of the sepsis, diagnostic tests would need to be ordered. The patient has had coagulation studies done and a complete blood count. Other diagnostic tests to be ordered include a blood chemistry panel, blood, sputum, urine cultures and gram stain and a chest x-ray. Since the causative organism of the pneumonia is unknown, a broad-spectrum antibiotic should be given within the first hour of recognition of sepsis. The antibiotic should cover gram-positive, gram-negative, and anaerobic bacteria. Also to be considered is the rise of methicillin resistant staph aureus. So, vancomycin or linezolid are two possible choices (Filbin 2008). Nursing care of the patient at this point would include closely monitoring vital signs, heart rhythm, hemodynamic parameters, lung sounds, oxygenation, hourly urine output, monitor coagulation studies and check for signs of bruising or bleeding, and provide nutritional support (Chulay & Burns 2006).
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