{"id":116342,"date":"2023-08-25T09:41:32","date_gmt":"2023-08-25T09:41:32","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=116342"},"modified":"2023-08-25T09:41:33","modified_gmt":"2023-08-25T09:41:33","slug":"nurs-misc-sepsis-case-study-urosepsis-jean-kelly-age-82-jean-kelly-is-an-82-year-old-woman-who-has-been-feeling-more-fatigued-the-last-three-days-and-has-had-a-fever-the-last-twenty-four-hours-she-r","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/08\/25\/nurs-misc-sepsis-case-study-urosepsis-jean-kelly-age-82-jean-kelly-is-an-82-year-old-woman-who-has-been-feeling-more-fatigued-the-last-three-days-and-has-had-a-fever-the-last-twenty-four-hours-she-r\/","title":{"rendered":"NURS MISC Sepsis Case Study; Urosepsis Jean Kelly age 82.Jean Kelly is an 82-year-old woman who has been feeling more fatigued the last three days and has had a fever the last twenty-four hours. She reports a painful, burning sensation when she urinates a"},"content":{"rendered":"\n<p>Urosepsis Jean Kelly age 82 Name: Christina Hammack<br>Jean Kelly is an 82-year-old woman who has been feeling more fatigued the last three days and has had a fever the last<br>twenty-four hours. She reports a painful, burning sensation when she urinates as well as frequency of urination the last<br>week. Her daughter became concerned and brought her to the emergency department (ED) when she did not know what<br>day it was. She is mentally alert with no history of confusion. While taking her bath today, she was weak and unable to<br>get out of the tub and used her personal life alert button to call for medical assistance.<br>Personal\/Social History:<br>Jean lives independently in a senior apartment retirement community. She is widowed and has two daughters who are<br>active and involved in her life.<br>What data from the histories are important and RELEVANT and have clinical significance for the nurse?<br>RELEVANT Data from Present Problem: Clinical Significance:<br>Progressively worsening fatigue, fever, and<br>painful, burning, and frequent urination.<br>Sudden onset of confusion (change in mental<br>status) with no prior history<br>Clinically significant symptoms of urinary tract infection prompting<br>request for an order for a urinalysis.<br>Confusion is a common presentation of UTI in the elderly, and change<br>in mental status from baseline should always be fully investigated.<br>RELEVANT Data from Social History: Clinical Significance:<br>Lives in a senior retirement community with<br>daughters who are actively involved in her<br>life and wears a life alert button<br>Jean has a strong support system and a safe place to return to after<br>discharge that will provide support. Her life alert button provides the<br>security she needs in the event of an emergency since she lives alone.<br>What is the RELATIONSHIP of your patient\u2019s past medical history (PMH) and current meds?<br>(Which medications treat which conditions-indicate with numbers or some form that I can identify<br>PMH: Home Meds: Pharm. Classification: Expected Outcome:<br>Diabetes type 2 1. Allopurinol 100 mg PO 1. Antigout agent<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>Antiplatelet\/salicylate<\/li>\n\n\n\n<li>Thiazolidinedione\/anti<br>diabetic<\/li>\n\n\n\n<li>Antihyperlipidemic<\/li>\n\n\n\n<li>Beta blocker<\/li>\n\n\n\n<li>Ace inhibitor<\/li>\n\n\n\n<li>Loop diuretic<\/li>\n\n\n\n<li>K supplement<\/li>\n\n\n\n<li>Decreased production<br>of uric acid to reduce gout<br>flares<\/li>\n\n\n\n<li>Reduce platelet<br>aggregation and clumping<br>to prevent clotting<\/li>\n\n\n\n<li>Reduces and controls<br>blood glucose levels<\/li>\n\n\n\n<li>Reduces cholesterol\/<br>blood lipid levels<\/li>\n\n\n\n<li>Reduces blood pressure<\/li>\n\n\n\n<li>Reduces blood pressure<\/li>\n\n\n\n<li>Reduces BP through<br>diuresis<\/li>\n\n\n\n<li>Replaces K in the body<br>lost through diuresis<br>Hyperlipidemia bid<br>Hypertension (HTN) 2. ASA 81 mg PO daily<br>Gout 3. Pioglitazone 15 mg PO<br>daily<\/li>\n\n\n\n<li>Simvastatin 20 mg PO<br>daily<\/li>\n\n\n\n<li>Metoprolol 25 mg PO bid<\/li>\n\n\n\n<li>Lisinopril 10 mg PO daily<\/li>\n\n\n\n<li>Furosemide 20 mg PO<br>daily<\/li>\n\n\n\n<li>Potassium chloride 20<br>mEq PO daily<\/li>\n<\/ol>\n\n\n\n<p>Urosepsis Jean Kelly age 82 Name: Christina Hammack<br>One disease process often influences the development of other illnesses. Based on your knowledge of<br>pathophysiology, (if applicable), which disease likely developed FIRST that then initiated a \u201cdomino effect\u201d in<br>their life?<br>\u25cf Circle what PMH problem started FIRST<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>DMII<br>\u25cf Underline what PMH problem(s) FOLLOWED as dominoes<\/li>\n\n\n\n<li>HTN, HLD (probably coexisted), Gout<\/li>\n\n\n\n<li>Wasn\u2019t exactly sure when Gout could have happened as it not necessarily linked to her other<br>comorbidities<br>Patient Care Begins:<br>Current VS: P-Q-R-S-T Pain Assessment (5th VS):<br>T: 101.8 F\/38.8 C (oral) Provoking\/Palliative: Nothing\/Nothing<br>P: 110 (regular) Quality: Ache<br>R: 24 (regular) Region\/Radiation: Right flank<br>BP: 102\/50 Severity: 5\/10<br>O2 sat: 98% room air Timing: Continuous<br>The nurse recognizes the need to validate his\/her concern of fluid volume deficit and performs a set of orthostatic<br>VS and obtains the following:<br>Position: HR: BP:<br>Supine 110 102\/50<br>Standing 132 92\/42<br>What VS data are RELEVANT and must be recognized as clinically significant by the nurse?<br>RELEVANT VS Data: Clinical Significance:<br>Temp of 101.8F<br>Pulse of 110<br>Respirations of 24<br>BP 102\/50<br>Orthostatic BP changes<br>Indicative of fever, systemic sign of infection<br>Tachycardia, heart is beating faster &#8211; could be sign of anxiety or<br>compensation of some sort<br>Tachypnea could also be a sign of anxiety or compensation<br>In combination with tachycardia, probably indicative of fluid volume<br>deficit in which heart beats faster to maintain pressure with the<br>decreased blood volume<br>Orthostatic hypotension defined as a systolic change of at least 20<br>between supine and standing which she demonstrates. Indicative of many<br>things but given her vitals and s\/s, this is consistent with fluid volume<br>deficit<br>Current Assessment:<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Urosepsis Jean Kelly age 82 Name: Christina HammackJean Kelly is an 82-year-old woman who has been feeling more fatigued the last three days and has had a fever the lasttwenty-four hours. She reports a painful, burning sensation when she urinates as well as frequency of urination the lastweek. Her daughter became concerned and brought her [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-116342","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/116342","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=116342"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/116342\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=116342"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=116342"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=116342"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}