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Bacteremia and Sepsis - Definition, Causes and Symptoms

Bacteremia and Sepsis


DEFINITIONS

  • Bacteremia is the presence of bacteria in the bloodstream.
  • Sepsis is an infection in the bloodstream.

CAUSES

Sepsis is the result of a bacterial infection in the human body.
Which is often the source of sepsis is an infection of the kidney, liver or gall bladder, intestines, skin (cellulitis) and the lungs (pneumonia due to bacteria).

Risk factors for sepsis:
  • Surgery on the infected part of the body or body parts which normally grow bacteria (eg intestine).
  • Insert foreign objects into the body, for example; intravenous catheter, urinary catheter or drainage hose.
  • Drug abuse by injection.
  • Patients with immune system disorders (eg, due to anti-cancer therapy).


SYMPTOMS

Transient bacteremia rarely cause symptoms because the body is usually able to eradicate a small number of bacteria immediately.

If someone sepsis, there will arise the following symptoms:
  • Fever or hypothermia (decreased body temperature).
  • Hyperventilation.
  • Chills.
  • The skin feels warm.
  • Skin rash.
  • Tachycardia (increased heart rate).
  • Delirious or dazed.
  • Decreased production of urine.
If not addressed, sepsis can lead to infection throughout the body (metastatic infection). Infections can occur in the lining of the brain (meningitis), in the pericardium (pericarditis), in the heart (endocarditis), in the bone (osteomyelitis) and in the large joints. An abscess (accumulation of pus) may develop in almost all parts of the body.

Signs and Symptoms of Hypoglycemia According to Experts

Hypoglycemia occurs due to an excess of insulin in the blood resulting in low blood sugar levels. Blood sugar levels can cause symptoms of hypoglycemia, varies between one another.

At first the body responds to low blood sugar levels by releasing epinephrine (adrenaline) from the adrenal glands and certain nerve endings. Epinephrine stimulates the release of sugar from body reserves but also causes symptoms that resemble anxiety attacks (sweating, restlessness, trembling, fainting, palpitations, and sometimes hunger). More severe hypoglycemia cause a reduction of glucose to the brain and cause dizziness, confusion, fatigue, weakness, headache, unusual behavior, inability to concentrate, impaired vision, convulsions and coma. Prolonged hypoglycemia can cause permanent brain damage. Symptoms that resemble anxiety and disruption of brain function can begin slowly or suddenly. It most often occurs in people who take insulin or oral hypoglycemic drugs. In patients with insulin-producing pancreatic tumor, symptoms occurred on the morning after an overnight fast, especially if the blood sugar stores are depleted by exercise before breakfast. At first only occasional episodes of hypoglycemia-time, but after a long time the attacks become more frequent and more severe.

Signs and symptoms of hypoglycemia consists of two phases include:
  • The first phase of the symptoms that arise as a result of activation of the autonomic centers in the hypothalamus so that the release of the hormone epinephrine. Symptoms include palpitations, out a lot of sweat, tremors, fear, hunger and nausea (glucose by 50 mg%).
  • The second phase is the symptoms that occur as a result of the start of the disruption of brain function, symptoms such as dizziness, blurred vision, decreased mental acuity, loss of fine motor skills, loss of consciousness, seizures and coma (blood glucose of 20 mg%).

The symptoms of hypoglycemia are not typical is the following:
  • Changes in behavior.
  • Syncope sudden attack.
  • Headache in the morning, which will disappear with the morning meal.
  • Excessive sweating bedtime.
  • Waking from sleep at night to eat.
  • Hemiplegia / aphasia passing.
  • Angina pectoris without coronary artery abnormalities.
Research on people who are not diabetic indicate a disturbance in brain function that is ahead of phase I and in the call subliminal brain dysfunction, in addition to symptoms that are not typical.
Sometimes symptoms do not appear adrenergic phase and direct patients away in the phase disruption of brain function, there are two types of loss of alertness, namely acute and chronic.
Acute example: in patients with type 1 diabetes mellitus with blood glucose control is very tight near normal, the neuropathy autonomic in a patient who had been suffering from diabetes, and use of beta-blockers are nonselective, loss of alertness that chronicles usually irreversible and is considered a complication of diabetes serious.
As a basic diagnosis of Whipple's triad can be used, ie hypoglycaemia with symptoms of central nervous, glucose levels less than 50 mg% and the symptoms will disappear with the administration of glucose.

Hypoglycemia in diabetes is more common than ketoacidosis, although most spread are those of insulin dependence. Onset of hypoglycemia is much faster and manifestations are more varied, often in ways that are not clear so as to deflect the attention of a person until the person does not realize what is actually happening and not being able to find a treatment that does not fit, so the reactions of hypoglycaemia due to insulin may occurred in the midst of everyday life of the patient. Although significant recovery, and hypoglycemia can be rapid and complete within a few minutes after an appropriate treatment, many patients are emotionally (psychologically possibility) remain shaken for several hours or even for several days after an insulin reaction. Finally, in conditions of extreme hypoglycemia, still has the possibility to cause permanent brain damage and even fatal. (Ester, 2000 :).


In the quotation from Karen Bruke 2005 there are few clinical signs and symptoms that include:
  • Hungry.
  • Nausea and vomiting.
  • Pale, cold skin.
  • Headache.
  • Rapid pulse.
  • Hypotension.
  • Irritability.
Manifestations cause changes in cerebral function:
  • Headache.
  • Coma.
  • Difficulty in thinking.
  • Inability to concentrate.
  • Changes in attitude emotion.

Nursing Care Plan for Hypoglycemia: Activity Intolerance


Nursing Care Plan for Hypoglycemia

Activity Intolerance related to imbalance of oxygen supply and demand, weakness.

Defining characteristics:
  • Fatigue and weakness.
  • The response to activity indicates abnormal pulse and blood pressure.
  • Changes in ECG showed arrhythmia / dysrhythmia.
  • Dyspnea and discomfort.
  • Agitated.
Goal: The client is able to achieve: activity tolerance,

with expected outcomes:

Activity Tolerance:
  • Oxygen saturation within normal limits when activity.
  • HR in the normal range when the activity.
  • Respiration in the normal range when the activity.
  • Systolic blood pressure in the normal range when the activity.
  • Diastolic blood pressure in the normal range when the activity.
  • ECG within normal limits.
  • Skin color.
  • Breathing efforts when the activity.
  • Walking in the room.
  • Walk away.
  • Climbing up the stairs.
  • ADL strength.
  • The ability to talk while exercising.

Interventions :

Therapeutic Activities:
  • Note the frequency of heart rhythm, changes in blood pressure before, during and after activity as indicated.
  • Increase rest, limit activity and provide leisure activities that are not heavy.
  • Limit visitors.
  • Monitor response to emotional, physical, social and spiritual.
  • Describe the pattern of a gradual increase in activity.
  • Help clients recognize a meaningful activity.
  • Help clients know the options for activity.
  • Determine the client's commitment to increase the frequency of the activity.
  • Collaboration related to the physical, recreational therapy, proper supervision activity program.
  • Help the client make a specific plan for the transfer of routine daily activity.
  • Help the client / family know all the quality of a shortage of activity.
  • Train the client / family about the role of physical, social, spiritual, sense activity in health care.
  • Help the client / family environment with a desire to adjust the activity.
  • Provide activities that increase attention in a certain period.
  • Facilitation replacement activity when the client has passed the deadline, energy and movement.
  • Provide an environment that is not harmful to walk as indicated.
  • Provide positive reinforcement for participation in the activity.
  • Help the client generates its own motivation.
  • Monitor the emotional, physical, social, and spiritual activities.
  • Help the client / family getting monitor progress toward achieving the goal.

Energy Management :
  • Observation of the client restrictions in activity.
  • Encourage to express feelings towards limitations.
  • Assess the factors that cause fatigue.
  • Monitor nutrition and adequate sources of energy.
  • Monitor the client for physical fatigue and emotional excess.
  • Monitor the cardiovascular response to activity.
  • Monitor patterns of sleep and duration of sleep / rest.
Dysrhythmia Management :
  • Knowing for certain clients and families who have a history of heart.
  • Monitor and check oxygenation deficiency, acid-base balance, electrolytes.
  • Record ECG.
  • Advise the client to break every attack.
  • Record the frequency and duration of the attack.
  • Monitor hemodynamic status.

More Complete About Symptoms of Stroke


Stroke is a condition when the blood supply to a part of the brain is suddenly interrupted. In brain tissue, in case of lack of blood flow will cause a series of biochemical reactions, which can be destructive and deadly nerve cells in the brain.

The death of brain tissue, may result in loss of function that is controlled by the tissue. Therefore, stroke, including diseases that cause death number 3 after the first HIV / AIDS, the second is a heart attack and the third is a stroke.

The most common symptoms of stroke known is suddenly paralyzed, the face looks down on one side, difficulty speaking, blindness, numbness, blurred vision, movement seemed unreal and difficult to balance until lost consciousness.

For more details about the symptoms of a stroke are as follows:

1. Paralysis in the limbs
Paralysis in the limbs of a sudden is a symptom of stroke. Could only right hand or left hand, can also be a weakness in the right hand and left hand. Weakness on the right foot or left foot. Or both legs.

2. Sensibility or impaired sense of touch half body
Impaired sense of numbness or tingling in the form of half body or a limb that occurs suddenly should be suspected as a symptom of stroke. If interference occurs, such as the loss or lack of sensation or tingling or shock sensation in the limbs half.

3. Facial nerve paralysis
Facial nerve paralysis is one of the symptoms of stroke were the most frequently reported. Which of these facial nerve paralysis caused a disturbance in cranial nerve number 7. The face of sudden asymmetry.

4. Aphasia or difficult to communicate
Losing the ability to communicate both verbally and non-verbally that occurs suddenly it also includes symptoms of a stroke. If someone is suddenly could not speak or do not understand the contents of the conversation, then that person should be suspected as a symptom of stroke.

5. Loss of speech or slurred speech
Loss of speech or slurred speech is one of the main symptoms of stroke.

6. Disorientation or sudden confusion
If a person experiences a sudden confused even experienced a loss of consciousness, then it should be suspected as a symptom of stroke. If someone lose their ability to recognize people, given the time and place that occurs suddenly, then this should be suspected as a symptom of stroke.


Stroke treatment is a race against time. If there are symptoms of a stroke immediately seek the right help quickly. With quick and precise handling will give good results.

Diagnosis pathology (stroke blockage or bleeding stroke) was determined with minimal CT scan of the head. Good handling at the beginning, the expected good results.