성인간호학실습 임상개념도 (Septic Shock)

문서 내 토픽

1. Septic Shock

Septic shock은 감염으로 인한 심각한 저혈압과 장기 부전을 동반하는 상태입니다. 이 경우 환자는 Alzheimer's disease와 흡인성 폐렴으로 인해 패혈증이 발생했습니다. 이로 인해 혈관 투과성 증가, 말초혈관 이완, 심근 수축력 저하 등이 나타나 저혈압과 장기 부전이 발생했습니다. 따라서 적절한 수액 공급, 승압제 투여, 기계 환기 등의 집중 치료가 필요합니다.
2. Aspiration Pneumonia

흡인성 폐렴은 연하 기능 저하로 인해 발생한 것으로 보입니다. 이로 인해 폐 실질 조직의 부종과 폐포 내 수분 이동이 발생하여 저산소증과 호흡 곤란이 나타났습니다. 따라서 기도 흡인, 체위 변경, 호흡기 치료 등의 간호 중재가 필요합니다.
3. Acute Kidney Injury

내독소에 의한 신장 혈관 수축과 전신 혈류량 감소로 인해 신장 관류가 저하되어 급성 신손상이 발생했습니다. 이로 인해 GFR 감소, 핍뇨 등의 증상이 나타났습니다. 따라서 수액 공급, 이뇨제 투여, 신대체 요법 등의 치료가 필요합니다.
4. Metabolic Acidosis

β-2 카테콜아민 수용체 활성화로 인해 해당 작용이 증가하여 젖산 생성이 증가했습니다. 이로 인해 대사성 산증이 발생했습니다. 따라서 산-염기 균형 모니터링과 함께 적절한 치료가 필요합니다.
5. Pressure Ulcer

기계 환기, 승압제 사용, 와상 상태 등으로 인해 말초 혈관 허혈과 의식 저하가 발생하여 욕창이 발생했습니다. 이는 전신 감염으로 이어질 수 있으므로 체중 확인, 부종 확인, 체위 변경, 피부 사정 등의 간호 중재가 필요합니다.

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1. Septic Shock

Septic shock is a life-threatening condition that occurs when the body's response to an infection leads to widespread inflammation, tissue damage, and organ failure. It is a medical emergency that requires prompt recognition and aggressive treatment. The key to managing septic shock is early identification of the underlying infection, rapid administration of appropriate antibiotics, and aggressive fluid resuscitation to maintain adequate tissue perfusion. Supportive care, including mechanical ventilation, vasopressor therapy, and renal replacement therapy, may also be necessary. Mortality rates for septic shock remain high, underscoring the importance of early recognition and prompt intervention. Healthcare providers must be vigilant in identifying and treating septic shock to improve patient outcomes.
2. Aspiration Pneumonia

Aspiration pneumonia is a serious condition that occurs when foreign material, such as food, liquid, or stomach contents, is inhaled into the lungs. This can lead to inflammation, infection, and potentially life-threatening complications. Risk factors for aspiration pneumonia include dysphagia, neurological disorders, altered mental status, and gastroesophageal reflux disease. Prompt recognition and treatment are crucial, as aspiration pneumonia can rapidly progress to respiratory failure and sepsis. Treatment typically involves antibiotics, respiratory support, and addressing the underlying cause of the aspiration. Prevention strategies, such as proper swallowing assessment, dietary modifications, and proactive management of risk factors, are essential to reduce the incidence of this condition. Healthcare providers must be vigilant in identifying and managing aspiration pneumonia to improve patient outcomes and prevent long-term complications.
3. Acute Kidney Injury

Acute kidney injury (AKI) is a sudden and often reversible decline in kidney function, which can lead to the accumulation of waste products in the body and the disruption of fluid and electrolyte balance. AKI can be caused by a variety of factors, including dehydration, sepsis, nephrotoxic medications, and underlying kidney disease. Early recognition and prompt treatment are crucial, as AKI can rapidly progress to life-threatening complications, such as fluid overload, electrolyte imbalances, and metabolic acidosis. Treatment typically involves addressing the underlying cause, providing supportive care, and, in severe cases, initiating renal replacement therapy. Prevention strategies, such as maintaining adequate hydration, avoiding nephrotoxic agents, and closely monitoring kidney function, are essential to reduce the incidence and severity of AKI. Healthcare providers must be vigilant in identifying and managing AKI to improve patient outcomes and prevent long-term kidney damage.
4. Metabolic Acidosis

Metabolic acidosis is a serious medical condition characterized by an abnormal accumulation of acid in the body, leading to a decrease in blood pH. It can be caused by a variety of underlying conditions, such as diabetic ketoacidosis, renal failure, and lactic acidosis. Symptoms of metabolic acidosis can include nausea, vomiting, fatigue, and rapid breathing. If left untreated, metabolic acidosis can progress to life-threatening complications, such as cardiac arrhythmias and coma. Prompt recognition and treatment are crucial, as the underlying cause must be addressed to restore normal acid-base balance. Treatment typically involves administering intravenous fluids, correcting electrolyte imbalances, and addressing the underlying condition. Prevention strategies, such as tight glycemic control in diabetic patients and early recognition of risk factors, are essential to reduce the incidence and severity of metabolic acidosis. Healthcare providers must be vigilant in identifying and managing metabolic acidosis to improve patient outcomes and prevent long-term complications.
5. Pressure Ulcer

Pressure ulcers, also known as bedsores, are localized areas of tissue damage that occur due to prolonged pressure on the skin and underlying tissues. They are a significant healthcare concern, as they can lead to pain, infection, and even life-threatening complications. Risk factors for pressure ulcers include immobility, poor nutrition, incontinence, and underlying medical conditions. Prevention is key, and strategies such as regular skin assessments, pressure redistribution, and nutritional support are essential. When pressure ulcers do develop, prompt and appropriate treatment is crucial to promote healing and prevent further complications. This may involve wound care, debridement, and addressing the underlying causes. Healthcare providers must be vigilant in identifying and managing pressure ulcers to improve patient outcomes, reduce the risk of complications, and minimize the burden on the healthcare system. Ongoing education and implementation of evidence-based practices are necessary to effectively prevent and manage this significant healthcare challenge.

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