what are 3 nursing diagnoses, smart goals, and interventions for "Septic shock secondary to pneumonia"

Sepsis

- An infection reaches the bloodstream and causes inflammation in the body.

- is a systemic response to infection; it may occur after a burn, surgery, or a serious illness and is manifested by two or more clinical symptoms: temperature of more than 38°C or less than 36°C, heart rate of more than 90 beats per minute, respiratory rate of more than 20 breaths per minute, PaCO₂ of below 32 mmHg, white blood cell count of more than 12,000 cells/mm³, less than 4,000 cells/mm³ or greater than 10% of bands or immature cells, hyperglycemia, bleeding, and abnormal clotting.

Severe sepsis. 

-The infection is severe enough to affect organ function.

Septic shock

- There's a significant drop in blood pressure that can lead to respiratory or heart failure, stroke, dysfunction of other organs, and possibly death.

Septic shock secondary to pneumonia

- septic shock is a frequent complication of pneumococcal pneumonia and causes high morbidity and mortality. Current tobacco smoking, chronic corticosteroid treatment and infection caused by S pneumoniae serotype 3 are independent risk factors for this serious complication.

3 nursing diagnoses

1. Risk For Infection

2. Risk For Shock

3. Risk For Impaired Gas Exchange

3 SMART GOALS

1. eliminating infection

2. maintaining adequate tissue perfusion or circulatory volume

3. preventing complications

3 interventions

• Strict infection control practices.
• Prevent central line infections. 
• Early debriding of wounds. 

Step-by-step explanation

Sepsis

- An infection reaches the bloodstream and causes inflammation in the body.

- is a systemic response to infection; it may occur after a burn, surgery, or a serious illness and is manifested by two or more clinical symptoms: temperature of more than 38°C or less than 36°C, heart rate of more than 90 beats per minute, respiratory rate of more than 20 breaths per minute, PaCO₂ of below 32 mmHg, white blood cell count of more than 12,000 cells/mm³, less than 4,000 cells/mm³ or greater than 10% of bands or immature cells, hyperglycemia, bleeding, and abnormal clotting.

Severe sepsis. 

-The infection is severe enough to affect organ function.

Septic shock

- There's a significant drop in blood pressure that can lead to respiratory or heart failure, stroke, dysfunction of other organs, and possibly death.

Septic shock secondary to pneumonia

- septic shock is a frequent complication of pneumococcal pneumonia and causes high morbidity and mortality. Current tobacco smoking, chronic corticosteroid treatment and infection caused by S pneumoniae serotype 3 are independent risk factors for this serious complication.

3 nursing diagnoses

1. Risk For Infection

Risk factors

• Compromised immune system.
• Failure to recognize or treat infection and/or exercise proper preventive measures.
• Invasive procedures, environmental exposure (nosocomial).

2. Risk For Shock

Risk For Shock

Shock: is a life-threatening condition that occurs when the body is not getting enough blood flow. This can lead to damage to multiple organs.

Risk factors

• Reduction of arterial/venous blood flow: selective vasoconstriction, vascular occlusion-intimal damage, microemboli.
• Relative or actual hypovolemia.

3. Risk For Impaired Gas Exchange

Risk For Impaired Gas Exchange

Nursing Diagnosis

• Risk for Impaired Gas Exchange

Risk factors

• Altered oxygen supply-effects of endotoxins on the respiratory center in the medulla (resulting in hyperventilation and respiratory alkalosis); hypoventilation.
• Altered blood flow (changes in vascular resistance), alveolar-capillary membrane changes-increased capillary permeability leading to pulmonary congestion.
• Interference with oxygen delivery and utilization in the tissues (endotoxin-induced damage to the cells and capillaries).

3 SMART GOALS

1. eliminating infection

- Infection prevention and control (IP&C) practices are important in maintaining a safe environment for everyone by reducing the risk of the potential spread of disease.

2. maintaining adequate tissue perfusion or circulatory volume

- Perfusion is the means by which blood provides nutrients and removes cellular waste. Adequate tissue perfusion-when supply meets demand-is necessary to maintain healthy vital tissue.

- Administer IV fluids as ordered. Sufficient fluid intake maintains adequate filling pressures and optimizes cardiac output needed for tissue perfusion. Note urine output. Reduce renal perfusion may take place due to vascular occlusion.

3. preventing complications

1. Get regular vaccinations against viral infections that may cause sepsis.
2. Practice good hygiene.
3. Care for and clean any open or gaping wounds.
4. Follow medical advice on managing bacterial infections.
5. Treat fungal and parasitic infections as soon as symptoms appear.
6. Control diabetes, if relevant.
7. Avoid smoking.

3 interventions

• Strict infection control practices. To prevent the invasion of microorganisms inside the body, infection must be put at bay through effective aseptic techniques and interventions.
• Prevent central line infections. Hospitals must implement efficient programs to prevent central line infections, which is the most dangerous route that can be involved in sepsis.
• Early debriding of wounds. Wounds should be debrided early so that necrotic tissue would be removed.