Harding Lewis Medical Question & Answer Guide (With Explanation)
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Original Question
Harding: Lewis’s Medical-Surgical Nursing, 11th Edition NGN Case Study Title: Sepsis Scenario: A 73-year-old male was taken to the Emergency Department by ambulance because his wife found him sitting up in his recliner, awake but not responsive. He takes sitagliptin daily for type 2 diabetes mellitus and a daily multivitamin. A rapid assessment reveals the following-opens eyes when his name is called; otherwise keeps them closed. Does not follow instructions. Skin warm and flushed. Heart rhythm regular, rate 114; ECG shows sinus tachycardia. BP 96/52; respirations 24. Temperature 101.5°F (38.6°C). SPO2 96% on room air; lungs clear to auscultation bilaterally. Abdomen soft, nondistended, with normoactive bowel sounds in all quadrants. Trace edema noted on ankles and shins bilaterally. The patient has a large bandage on his right arm; his wife explained that he cut himself badly when gardening a few days ago and they wrapped it with a bandage to stop the bleeding. The wound on the right forearm is 3.2 cm long, 0.5 cm wide, and 0.2 cm deep, with redness around the wound and a moderate amount of yellowish drainage on the bandage. Laboratory results are listed below. The stroke team evaluated the patient using the NIH Stroke Scale; the evaluation was negative for a stroke. A STAT CT scan came back normal. Laboratory Results: Na 144 mEq/L K 4.9 mEq/L Glu 134 mg/dL BUN 22 mg/dL Creatinine 1.4 mg/dL Lactic acid 2.9 mg/dL Procalcitonin 0.6 ng.mL WBC 19.2 1000/mm3 Hgb 16 g/dL Hct 44% Platelet count 249,000 mm3 mg/dL BUN 22 mg/dL Creatinine 1.4 mg/dL Lactic acid 2.9 mg/dL Procalcitonin 0.6 ng.mL WBC 19.2 1000/mm3 Hgb 16 g/dL Hct 44% Platelet count 249,000 mm3 Please provide a paragraph to answer each question: What is sepsis? How is sepsis diagnosed? How does sepsis affect the body? What are common signs and symptoms of sepsis? Why was the patient not as responsive? Why did the patient have an increased heart rate? How does the lactic level correlate with a sepsis diagnosis? Explain the WBC results. What is the source of infection for this patient? How is sepsis treated? What indicators suggest an improvement in patient status? The patient has a history of diabetes, should he continue to take his medication? Explain you answer What is the patient at risk of? What is the mortality rate of patients diagnosed with severe sepsis?
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