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Intensive Care Nursing/Sepsis Scenarios/Medical Sepsis Unfolding Case Study

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Background and Arrival In The Emergency Department

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MP is an 83-year-old female patient is brought to the emergency department from a Skilled Nursing Facility (SNF) due to progressing altered mental status and dysuria/pyuria over the past 3 days. Family was notified by the SNF and is on their way.

On arrival the patient is connected to the monitor and vital signs are as followed:

Temperature: 38.5 C (101.3 F)

HR: 122

BP: 85/50

RR: 18

SpO2: 95% @ RA

White Blood Cell count: 16k/microliter

Lactate: 2.5

1 The provider in the ED has ordered a fluid bolus on account of their hypotension. Which of the following orders do you also anticipate seeing?

Urine culture
Blood culture
Antibiotics
Purified Protein Derivative (PPD skin test)

2 Which of the vital signs or labs are most concerning to you at this time?

Lactate
Oxygen Saturation
Respiratory rate
White Blood Cell count


  1. Medical Sepsis Scenario p2