Postoperative Sepsis
A 58-year-old client is on postoperative day 2 after abdominal surgery. The nurse is called because the client has become confused and is not acting like themselves.
Recognize cues
Vital signs: temperature 38.9 C, HR 118, BP 86/48, RR 26, SpO2 93% on room air. The client is oriented to person only. Skin is warm and flushed. The abdominal incision is clean and dry. Urine output has been 15 mL/hr for the last 3 hours.
Which combination of findings most strongly suggests sepsis?
Take action
The rapid response team is activated. Orders include blood cultures x2, lactate level, 30 mL/kg isotonic fluid bolus, and broad-spectrum IV antibiotics.
Which two actions should the nurse complete first?
Evaluate outcomes
After the fluid bolus and the first antibiotic dose: BP 104/64, HR 96, RR 20, urine output 45 mL/hr, lactate down from 4.2 to 2.1 mmol/L. The client is oriented to person and place.
Which findings indicate the interventions are effective? Select the two best indicators.
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