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ncp neonatal sepsis

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ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATION SUBJECTIVE: “Walng gana dumede ang anak ko, parang mainit sya at matamlay” (it’s difficult to feed my baby, she feels warm to touch and not very active) as verbalized by the mother. OBJECTIVE: Increased body temperature. Flushed skin. Increased respiratory rate. V/S taken as follows: T: 37.7 P: 130 R: 45 Risk for infection related to compromised immune system. Sepsis is a clinical term used to describe symptomatic bacteremia, with or without organ dysfunction. Sustained bacteremia, in contrast to transient bacteremia, may result in a sustained febrile response that may be associated with organ dysfunction. Septicemia refers to the active multiplicati on of bacteria in the After 8 hours of nursing intervention s, the patient will achieve timely healing and free from further infection. INDEPENDENT: Provide isolation and monitor visitors as indicated. Wash hands before or after each care activity, even gloves are used. Limit use of invasive devices or procedure as possible. Inspect wounds or site of invasive devices, paying particular attention to parenteral lines. Maintain sterile technique when changing dressings, suctioning or providing site care. Provide tepid sponge bath and avoid use of alcohol. Observe for chills and profuse diaphoresis. Monitor for signs of deterioration of condition or failure to improve in therapy. COLLABORATIVE: Obtain specimens of urine, blood, sputum, wound as indicated for gram stain, and sensitivity. Administer antibiotics as prescribed. Body substance isolation (BSI) should be used for all infectious patients. Reverse isolation/restriction of visitors may be needed to protect the immunosuppressed patient. Reduces risk of cross contamination because gloves may have noticeable defects, get torn or damaged during use. Prevents spread of infection via airborne droplets. May provide clue to portal entry, type of primary infecting organisms, as well as early identification secondary infection. Prevents introduction of Bacteria, reducing risk of nosocomial infection. Used to reduce fever. Chills often precede temperature spikes in presence of generalized infection. May reflect inappropriate antibiotic therapy or overgrowth of secondary infections. Identification of portal entry and organism causing After 8 hours of nursing intervention s, the patient was able to achieve timely healing and free from further infection.

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Page 1: NCP Neonatal Sepsis

ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATIONSUBJECTIVE:“Walng ganadumede anganak ko, parangmainit sya atmatamlay” (it’sdifficult to feed mybaby, she feelswarm to touch andnot very active) asverbalized by themother.OBJECTIVE:Increasedbodytemperature.Flushed skin.Increasedrespiratoryrate.V/S taken asfollows:T: 37.7P: 130R: 45

Risk forinfection relatedto compromisedimmunesystem.

Sepsis is a clinicalterm used todescribesymptomaticbacteremia, with orwithout organdysfunction.Sustainedbacteremia, incontrast totransientbacteremia, mayresult in asustained febrileresponse that maybe associated withorgan dysfunction.Septicemia refers tothe activemultiplication ofbacteria in thebloodstream thatresults in anoverwhelminginfection.

After 8 hours ofnursinginterventions,the patient willachieve timelyhealing and freefrom furtherinfection.

INDEPENDENT:Provide isolation and monitor visitors as indicated.Wash hands before or after each care activity, even gloves are used.Limit use of invasive devices or procedure as possible.Inspect wounds or site of invasive devices, paying particular attention to parenteral lines.Maintain sterile technique when changing dressings, suctioning or providing site care.Provide tepid sponge bath and avoid use of alcohol.Observe for chills and profuse diaphoresis.Monitor for signs of deterioration of condition or failure to improve in therapy.COLLABORATIVE:Obtain specimens of urine, blood, sputum, wound as indicated for gram stain, and sensitivity.Administer antibiotics as prescribed.

Body substance isolation (BSI) should be used for all infectious patients. Reverse isolation/restriction of visitors may be needed to protect the immunosuppressed patient.Reduces risk of cross contamination because gloves may have noticeable defects, get torn or damaged during use.Prevents spread of infection via airborne droplets.May provide clue to portal entry, type of primary infecting organisms, as well as early identification secondary infection.Prevents introduction of Bacteria, reducing risk of nosocomial infection.Used to reduce fever.Chills often precede temperature spikes in presence of generalized infection.May reflect inappropriate antibiotic therapy or overgrowth of secondary infections.Identification of portal entry and organism causing the septicemia is crucial in effective treatment.To prevent further spread of infection.

After 8 hours ofnursinginterventions,the patient wasable to achievetimely healingand free fromfurtherinfection.


Neonatal Sepsis - Sudbury Journal Club · neonatal sepsis 2. Understand pathophysiology of neonatal sepsis 3. Describe the clinical presentation of neonatal sepsis 4. Understand underlying

Sepsis neonatal

Neonatal Sepsis