401211: Health Variations 4 Acute Life Threatening Conditions - Mr. Kirkman Case Study - Arterial Blood Gases - Nursing Assignment Help

Assessment Task:

Case Study Details:

Mr Kirkman a 75-year-old male, presented to ED complaining of burning sensation upon urination and lower abdominal pain radiating into the right flank. Mr Kirkman was admitted to the ward with a diagnosis of Urinary tract infection. He was placed on IV NaCl and IV Sulfamethoxazole-trimethoprim 10 mg/kg/day IV in 2 equally divided doses daily and an Indwelling catheter was inserted. Twenty-four hours later, his condition deteriorates HR135, BP 80/42, RR 35, TEMP 39 and looks generally unwell.

History from ED notes

1.  Wife died 12 months ago
2.  Social drinker
3.  Heavy smoker 2 packs a day since commencing as a teenager.
4.  Chronic bronchitis on Ventolin and Atrovent.
5.  Previous UTI
6.  No cardiac history

Diagnosis 24 hours later

•  UTI with severe sepsis

PRIMARY SURVEY O/E
A – Patient speaking in single words
B – RR 35bpm, accessory muscle use. SPO2 82%, in obvious distress.
C – Sinus rhythm 135bpm, Blood pressure 80/42mmHg, Temperature 39°C
D – E4, V4, M5
E- Use of accessory muscles, lower abdominal pain 6/10, flushed face
F- IVC insitu, IDC- Dark urine passed small amounts approximately 40mls in last 8 hours
G- 8.4mmol/L

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