Question

A 78-year-old man has confusion and temperature of 104° F (40° C). He is a diabetic with purulent drainage from his right heel. After an infusion of 3 L of normal saline solution, his assessment findings are BP 84/40 mm Hg; heart rate 110; respiratory rate 42 and shallow; CO 8 L/minute; and PAWP 4 mm Hg. This patient's symptoms are most likely indicative of

a.sepsis.
b.septic shock.
c.multiple organ dysfunction syndrome.
d.systemic inflammatory response syndrome.

Answer 1

A 78-year-old man with confusion, high fever, and signs of infection, along with hemodynamic instability despite fluid resuscitation, is most likely experiencing septic shock.

Step-by-step explanation:

A 78-year-old man presenting with confusion and a high temperature, along with purulent drainage from his right heel and a history of diabetes, is likely suffering from a systemic infection that has triggered a severe response in his body. After receiving 3 liters of normal saline, his blood pressure remains low at 84/40 mm Hg, his heart rate is elevated at 110 beats per minute, his respiratory rate is high and shallow at 42 breaths per minute, his cardiac output is 8 L/minute, and his pulmonary artery wedge pressure (PAWP) is quite low at 4 mm Hg. These findings, particularly in the context of an infection, indicate that the most likely diagnosis is septic shock.