Aquifer Case Study
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Aquifer Case Study
The report covers the case of a 78-year-old male experiencing fever, anorexia and lethargy.
Q.1 List of Appropriate Differential Diagnosis
Sepsis: The test is to uncover the suspected source of urinary tract infection (UTI). According to the case, the patient has hypothermia and is showing symptoms of acute delirium. The case indicates the patient also has tachycardia, elevated lactic acid levels and hypotention, which could all be indicative of sepsis.
UTI: The UA findings indicate the possibility of infection (elevated white blood cells and leukocyte esterase 2+). The daughter states her father has foul-smelling urine and incontinence. The patient also has an altered mental state, which is a sign of UTI infection in old adults.
Dehydration: The patient reports poor fluid and oral intake and hypernatremia. Dehydration is quite common in older adults due to a decline in internal water.
Q.2 Final Diagnosis, Normal and Abnormal Findings
Most indications highlight the patient is suffering from sepsis. Based on the results of the physical exam, lab results and vital signs, the patient’s information correlates with documented signs of sepsis, which are heart rate above 90bpm, fever above 38C or below 36C and a breathing rate above 20 breaths a minute (O’Connell, 2018). The patient has a temperature above 38 Celsius. The patient might have a UTI according to lab findings and the secondary information provided by the daughter.
Q.3 Pathophysiology
Viruses, fungi or bacteria gain access to the human blood stream to generate bacterium in two ways; (1) indirectly via toxic materials disposes by bacteria into the blood or (2) directly through the site of infection (Evans, 2018). The toxic substances induce a reaction from the septic syndrome, including the secretion of endotoxins, pedtodoglycan and lipoteichoic acids (Gyawali et al. 2019). Super-antigens produce the toxic substances.
Q.4 Recommended Pharmacological Treatment
The best course of medical action would be to administer antibiotic treatment using a wide array of spectrum four antibiotics. Pain killers to induce comfort, corticosteroids to reduce the rate of inflammation, insulin to regulate insulin levels and vasoactive antibiotics to improve blood pressure (O’Connell, 2018). Fluid replacement using below 1% sodium chloride solution is equally recommended. Dialysis would be necessary if there were signs showing significant kidney damage.
References
Evans, T. (2018). Diagnosis and management of sepsis. Clinical Medicine, 18(2), 146–149. https://doi.org/10.7861/clinmedicine.18-2-146
Gyawali, B., Ramakrishna, K., & Dhamoon, A. S. (2019). Sepsis: The evolution in definition, pathophysiology, and management. SAGE Open Medicine, 7. https://doi.org/10.1177/2050312119835043
O’Connell, K. (2018, August 31). Sepsis: Symptoms, Causes, Treatment, Risks & More. Healthline. https://www.healthline.com/health/sepsis.