Question

"p. 825, Patient-Centered Care; Evidence-Based Practice

The patient is an 82-year-old woman who has been a resident in an extended-care facility for the past year because of poor mobility and self-care problems. Today she is brought to the emergency department because she does not recognize her son and does not know where she is. She completed drug therapy for a urinary tract infection 1 week ago. Her skin is thin, and she has many bruises. In addition, she has a healing wound on her left shin, which her son tells you occurred 3 days ago when she scraped the area trying to get out of bed alone. The skin immediately surrounding the wound appears normal; however, about 3 inches to the right of the wound the skin is red, firm, and warm to the touch. These are her vital signs: T, 100.8 F (38.2 C); P, 112 beats/min; R, 24 breaths/min; BP, 118/80; SpO2, 92%. Oxygen at 3 L/min is applied until the neurologist can evaluate her, and an IV with normal saline is started at 100 mL/hr. Her son is concerned because she was given her oral antidiabetic drug this morning (5 hours ago) but has not eaten breakfast or lunch. When you check her blood glucose level, it is 131 mg/dL. When you assess her 15 minutes later, her oxygen saturation is 90%.
1. What risk factors does this patient have for sepsis?

Answer 1

This patient has several risk factors for sepsis including being elderly, recent urinary tract infection, poor mobility and self-care problems, thinness of skin and bruises, a healing wound with surrounding redness, firmness, and warmth, and an elevated temperature.

Step-by-step explanation:

This patient has several risk factors for sepsis:

1. Elderly: Being 82 years old puts the patient at a higher risk for developing sepsis due to a weakened immune system.
2. Urinary tract infection: The patient recently completed drug therapy for a urinary tract infection, which can be a source of infection and increase the risk of sepsis.
3. Poor mobility and self-care problems: These issues may lead to skin breakdown and wounds, which can become infected and progress to sepsis.
4. Thinness of skin and bruises: Fragile and thin skin is more prone to injury and infection, increasing the susceptibility to sepsis.
5. Healing wound with surrounding redness, firmness, and warmth: These are signs of inflammation and could indicate infection that may progress to sepsis.
6. Elevated temperature: The patient has a fever of 100.8°F (38.2°C), which is a sign of infection and an indicator of sepsis.