case study Septic Shock-Student.docx - Case Study Brief...

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Case Study Brief Patient History Mr. Z is a 38-year-old Hispanic construction worker who sustained a liver laceration after falling from a roof. He required an exploratory laparotomy for splenectomy and repair of the liver laceration 4 days earlier. His medical history reveals no chronic health problems, although he smokes 20 packs of cigarettes per year. Clinical Assessment Mr. Z is admitted to the medical intensive care unit from the telemetry unit with acute respiratory insufficiency and hypotension. He is using his accessory muscles to breathe. He is speaking Spanish. Mr. Z’s abdomen is distended, and there are no bowel sounds. Small amounts of dark green drainage are visible in the nasogastric tube. There is no sign of redness or drainage around his surgical wound. Diagnostic Procedures Vital signs were as follows: blood pressure of 78/55 mm Hg, heart rate of 142 beats/min (sinus tachycardia), respiratory rate of 35 breaths/min, temperature of 103.1° F, and urine output of 20 mL over the past 8 hours. ABG values on a 100%
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