Severe Sepsis Nursing Care: Monitoring, Infection Control, and Life-Saving Support Strategies

Severe sepsis is a system-wide infectious illness with a very high rate of mortality and, therefore, a very cautious and careful treatment is absolutely necessary. Later in this article, I will share with you some nursing knowledge related to severe sepsis.

I. Condition monitoring

Extremely close condition monitoring is a must for severe sepsis patients, thus, regular follow-up of vital signs such as heart rate, body temperature, blood pressure, and respiratory rate is going on. Hypothermia or hyperthermia indicates a change in the condition, and if hyperthermia occurs, it indicates that the patient’s infection is not well controlled; if the body temperature does not rise, it indicates that the patient’s condition is serious. In addition, if a rise in respiratory rate accompanies an increase in heart rate, it indicates that the patient’s body is executing a compensatory response during the reaction to the infection, which is also a very important signal of the progression of the condition. Blood pressure within stable limits is essential to organ perfusion, and a drop in blood pressure, therefore, indicates the onset of shock.

II. Infection control

During the performance of various nursing operations like catheterization, venipuncture, and tracheal intubation, nursing staff should strictly abide by the principles of aseptic operation to guarantee the sterility of the medical device as well as the surrounding environment and, thus, avoid cross-infection. If the patient has a wound, the skin at the wound site, on the other hand, must be dry and clean, the dressing changed regularly, and closely observed for signs of infection such as exudation, redness, and swelling. Caregivers are obliged to stick to the doctor’s instructions and use antibiotics correctly for their patients, focusing on the route of administration, time, and dosage, and closely observing post-medication reactions. At the same time, it takes good care of patients and provides them with personal hygiene assistance such as oral care and regular body scrubbing to lower the risk of bacterial growth.

III. Respiratory support

For most of the sufferers of extreme sepsis respiratory dysfunction occurs and thus among these patients respiratory support has to be given properly. In patients who are short of breath, the medical staff adjusts the oxygen flow and concentration according to the oxygen saturation value. When respiratory failure is severe, the patient may have to be put on a ventilator, and in such a case, the caregiver will be next to the patient’s breathing, watching whether the machine-assisted breathing is going well or not. Besides that, the nurses carry out the regular and necessary respiratory care for the patient, and the care includes such operations as the airway humidification and the suction of sputum. By the process of humidification, the airways can be kept at the desired level of moisture, and the dry knots of sputum can be prevented from blocking the airways; the suction of sputum can help remove the sputum and prevent lung infections.

IV. Circular support

Support of the circulatory system is the focal point in the treatment of sepsis at the stage when it is life-threatening. Active fluid resuscitation is the key to turning the patient’s condition around, especially in the early stages of the disease. The nursing staff will document the patient’s urine output, infusion volume, vomit volume, etc. and monitor the cardiopulmonary function closely to avoid the occurrence of heart failure and pulmonary edema due to excessive fluid replacement.

Meanwhile, if the patients are supposed to undergo treatment with vasoactive drugs, the nursing staff will be responsible for the speed of drug infusion, which they will strictly control to make sure the patient receives the correct dosage; at the same time, they will check parameters like heart rate and blood pressure, etc., and promptly adjust the medication in accordance with the levels of blood pressure. In addition, the effect of circulatory support was judged by the signs of the periphery such as the color and temperature of the patient’s skin.

V. Nutritional support

Normally, the patients with severe sepsis are in a hypermetabolic state that requires huge energy consumption and they should be provided with proper nutritional support. For the patients who can take food by mouth, the caregiver will be their early intake guide after which he will provide them with food that is high in proteins, calories, rich in vitamins and easy to digest; otherwise, if they are not able to eat by mouth, nutritional support through gastrointestinal fistula or nasogastric feeding will be adopted. Care should still be taken during the control of concentration, temperature and infusion rate to make sure there is no gastrointestinal discomfort. Moreover, the patient’s serum protein level and body weight changes are monitored regularly to ensure that nutrition support regimens can be adjusted in time.

Severe sepsis is a life-threatening disease, and its caregiving requires multi-dimensional and meticulous interventions. I believe that this article is a good starting point for deepening our understanding of the subject matter of severe sepsis and working jointly with healthcare professionals.

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