Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well. She is currently undergoing chemotherapy for bladder cancer. She has an indwelling urinary catheter with scant amount of dark, foul smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50 and RR 28. She is allergic to penicillin and Sulfa.
- What type of shock is she experiencing?
The patient is experiencing septic shock. The patient is also exhibiting signs of a urinary tract infection with complications of septicemia.
- What interventions do you anticipate the doctor will order?
I would anticipate for the MD to conduct a urine culture, fluid maintenance, IV antibiotics, and a CBC because the patient is on chemotherapy. The MD might also order a vasopressor which constricts the blood vessels and increases the blood pressure to keep the organs from shutting down.
- What can you teach this patient about prevention of infection?
I would teach the patient the importance of maintaining proper hygiene while handling the catheter, regular changing of the catheter, wipe front to back after using the restroom, urinate immediately after intercourse, wear cotton underwear, and consuming plenty of water to maintain a healthy urinary tract
- The doctor orders Bactrim. What should you be concern about? Why?
The patient is allergic to Sulpha and the doctor has prescribed Bactrim which is a combination drug that consist of Sulpha. I would be concerned because the patient is allergic to the prescribed medication but also needs immediate antibiotic therapy.Â
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