INSTRUCTIONS: There are 13-questions in this case study. You must respond to
all questions to receive credit.
ALL answers need to be supported by information from the scenario AND/OR
textbook AND/OR scholarly sources. Simple “yes” or “no” response is not
adequate.
For example, Question #6, the response requires more than just “yes” or “no”.
You must explain/support your response. What assessment data leads you to the
conclusion whether the pt. is or is not improving?
Scenario: Marie is a 27 year old female who is homeless. She arrives at the
emergency department with complaints pain in her left foot. After an
assessment you discover that she has an open wound on the bottom of her
left foot that is red, swollen, and draining green fluid. Cellulitis is present
up the leg to the knee. She states she has no chronic medical illnesses and
doesn’t take any medication. She is alert and oriented to person, place and
time. Her vitals are BP: 100/78 (her normal is 120/80), Heart Rate 100,
Temperature 100.5, Pulse Ox 98%, respiratory rate is 22.
1. What condition are you suspecting?
2. Does she have at least 2 criteria for Systemic Inflammatory Response
Syndrome? If so, list the criteria.
3. What are your next steps?
4. What medication do you expect to be given, if any?
5. What labs do you expect the doctor to order?
Abnormal lab results come back as:
Lactate: 4.2
WBC: 15,000
HCT: 42
After fluids were given the vitals were rechecked: BP 88/67, HR114, RR 28,
and Temperature 101.5. She states she feels chills. Patient appears pale.
6. Is she improving?
7. What do you expect the licensed practitioner to order?
The patient arrives to the intensive care unit and is monitored. Fluids and the
IV antibiotics continue. Approximately 4 hours after the initial lactate results
were completed, they drew another lactate blood sample. The results were
now 2.4. The patient remains in the ICU for 2days until she is transferred to
the medical surgical floor for monitoring.
8. If she was not improving, what would she be at risk for?
ADDITIONAL QUESTIONS (response to all is required):
9. What makes a person high risk for infection?
10. Define sepsis
11. In your own words, explain septic shock?
12. In your own words, explain the pathophysiology of Septic shock:
13. Give 2 examples of medications that can be used to treat Sepsis:
