Sepsis Case study (Urosepsis Jean Kelly age 82 )

Jean Kelly is an 82-year-old woman who has been feeling more fatigued the last three days and has had a fever the last twenty-four hours. She reports a painful, burning sensation when she urinates as well as frequency of urination the last week. Her daughter became concerned and brought her to the emergency department (ED) when she did not know what day it was. She is mentally alert with no history of confusion. While taking her bath today, she was weak and unable to get out of the tub and used her personal life alert button to call for medical assistance. Personal/Social History: Jean lives independently in a senior apartment retirement community. She is widowed and has two daughters who are active and involved in her life. What data from the histories are important and RELEVANT and have clinical significance for the nurse? RELEVANT Data from Present Problem: Clinical Significance: Progressively worsening fatigue, fever, and Clinically significant symptoms of urinary tract infection prompting painful, burning, and frequent urination. request for an order for a urinalysis. Sudden onset of confusion (change in mental Confusion is a common presentation of UTI in the elderly, and change status) with no prior history in mental status from baseline should always be fully investigated. RELEVANT Data from Social History: Clinical Significance: Lives in a senior retirement community with Jean has a strong support system and a safe place to return to after daughters who are actively involved in her discharge that will provide support. Her life alert button provides the life and wears a life alert button security she needs in the event of an emergency since she lives alone. What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds? (Which medications treat which conditions-indicate with numbers or some form that I can identify PMH: Diabetes type 2 Hyperlipidemia Hypertension (HTN) Gout Home Meds: 1. Allopurinol 100 mg PO bid 2. ASA 81 mg PO daily 3. Pioglitazone 15 mg PO daily 4. Simvastatin 20 mg PO daily 5. Metoprolol 25 mg PO bid6. Lisinopril 10 mg PO daily7. Furosemide 20 mg PO daily 8. Potassium chloride 20 mEq PO daily Pharm. Classification: 1. Antigout agent 2. Antiplatelet/salicylate 3. Thiazolidinedione/antidiabetic 4. Antihyperlipidemic 5. Beta blocker 6. Ace inhibitor 7. Loop diuretic Expected Outcome: 1. Decreased production of uric acid to reduce gout flares 2. Reduce platelet aggregation and clumping to prevent clotting 3. Reduces and controls blood glucose levels 4. Reduces cholesterol/ blood lipid levels 5. Reduces blood pressure 6. Reduces blood pressure 7. Reduces BP through diuresis 8. Replaces K in the body lost through diuresis 8. K supplement