Page 65 - English For Nursing

Skin is pale, dry and hot. Heart rate 110, respiratory rate 24, blood pressure 100/60. An oral thermometer is not
available.
Focused assessment of the patient’s foot reveals a one-inch laceration with no active bleeding that is

red, swollen and painful. Swelling is present throughout the bottom of her foot and ankle. Since the patient does
not appear to be in any acute distress, the medics suggest that she go to the local urgent care center in the morning
and a refusal is obtained.
The next morning, medics are dispatched to the urgent care center for a transfer to the local hospital for
hypotension. Upon arrival, the same medics find the above-mentioned patient with a blood pressure of 86/40
and a heart rate of 140. Tympanic temperature of 101.5 was obtained by the urgent care staff. The patient is
urgently transported to the local emergency department. During transport, medics infuse 500 mL of normal

saline per protocol for the management of medical hypotension.
At the emergency department, blood cultures are drawn, ibuprofen is administered for her fever, and
she is admitted to the hospitalist service. Antibiotics for cellulitis from an infected wound are started once she is
admitted. Her blood pressure continues to worsen throughout the night, and she is intubated and moved to the
ICU. Despite blood pressure support and aggressive antibiotic treatment, the patient dies 24 hours after arriving

at the hospital. The young patient in the above description died from septic shock secondary to her foot wound.
Adapted from: https://www.ems1.com/ems-products/capnography/articles/3-scenarios-to-train-for-diagnosis-treatment-of-sepsis-
pYAoKGarKW6P3C09/

1. What symptoms did the patient have at the beginning?
____________________________________________________________________________________
2. How long did the patient survive until finally died from the septic shock?
____________________________________________________________________________________
3. What was supposed to be done to save the patient from the worst death scenario?

____________________________________________________________________________________
Below is a table consisting information about symptom medical notes based on the septic
shock as narrated in the previous passage. Complete the table based on your
understanding in brief.

Patient Name : _____________________
Patient age: ________________________

Chronological Notes
Time Events, Conditions, and Treatments
Day 1 She cuts her foot on a piece of glass while walking in the ocean
Patient’s Condition:
______________________________________________________________
Day 2
______________________________________________________________
______________________________________________________________

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