Intensive Care Nursing/Sepsis Scenarios/Medical Sepsis Unfolding Case Study 2/Medical Sepsis Scenario 2 p2/Medical Sepsis Scenario 2 p3

The next day

When you return for your shift the next day, the EEG showed no acute findings and the CT showed some swelling. The results from the lumbar puncture showed low glucose levels, increased protein and white blood cells, and a gram stain which was positive for gram negative bacteria which all pointed to bacterial meningitis as the culprit of the patient’s symptoms. MB's blood pressure had decreased overnight with norepinephrine needing to be started to maintain their blood pressure.

Current vital signs are:

Temperature: 38.7 C (101.6 F)

HR: 115

BP: 94/61

RR: 19

SpO2: 98% on room air

Preliminary results from urine and blood cultures drawn on admission have been negative for any bacteria

1 Which of the vital signs and/or labs are concerning to you at this time?

	Temperature
	Lumbar puncture gram stain
	Respiratory Rate
	CT showing cerebral swelling

2 As you report your critical results (lumbar puncture results) according to your policy, what else would be appropriate to note in your SBAR communication to the provider?

	CT showing cerebral swelling
	Temperature
	Respiratory rate
	Heart Rate