P5 CASE SCENARIO Flashcards
A 60-year-old woman with stage IV cervical carcinoma undergoes extensive pelvic surgery (pelvic exenteration) in order to remove the tumor. The surgical procedure involves removal of all pelvic organs, removal of a segment of the ileum to construct a new bladder, and a colostomy. At first, the patient appears to be recovering very nicely. During the evening of the third postoperative day, however, the nurse on the night shift notes that the patient’s respiratory rate, which was 16-18 per min, has increased to 26 per min. The patient claims that she doesn’t feel overly sick. She is not short of breath or in pain, and her temperature is actually slightly subnormal (36.2ºC). By the next morning, she has slight fever (38.3ºC), but she continues to feel reasonably good. Her surgical wound shows no signs of infection, and her abdomen is no more tender than expected. Later in the day, however, it becomes quite clear that the patient is in serious trouble. She is flushed, anxious, and restless. Her BP has dropped from 135/75 to 105/55, and her temperature is 39.2ºC
what is your diagnosis ?
sepsis
