Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well.

Your patient is a 42-year-old female that arrives in the ED with complaints of fever and not feeling well. She is currently undergoing chemotherapy for bladder cancer. She has an indwelling urinary catheter with scant amount of dark, foul smelling urine. She has a temperature of 102.2F, HR 136, BP 110/50 and RR 28. She is allergic to penicillin and Sulfa.
What type of shock is she experiencing?
What interventions do you anticipate the doctor will order?
What can you teach this patient about prevention of infection?
The doctor orders Bactrim. What should you be concern about? Why?
Minimum of 250 words.

ANSWER
**Type of shock**

The patient is most likely experiencing **septic shock**. Septic shock is a type of distributive shock caused by a severe infection. It is characterized by hypotension, tachycardia, and tachypnea. The patient may also have a fever, chills, and confusion.

**Interventions**

The doctor will likely order the following interventions:

* **Fluid resuscitation:** This involves giving the patient intravenous fluids to increase blood pressure and improve tissue perfusion.
* **Antibiotics:** The doctor will prescribe antibiotics to treat the infection. The choice of antibiotic will depend on the type of infection suspected.
* **Vasopressors:** Vasopressors are medications that can be used to increase blood pressure. They may be used in patients who are not responding to fluid resuscitation alone.
* **Organ support:** The patient may need organ support, such as mechanical ventilation, if they develop organ failure.

**Teaching the patient about prevention of infection**

The following are some things you can teach the patient about prevention of infection:

* **Wash your hands frequently with soap and water.** This is the best way to prevent the spread of infection.
* **Keep your urinary catheter clean and dry.** Clean the catheter insertion site with soap and water at least once a day.
* **Drink plenty of fluids.** This will help to keep your urine flowing and to flush out bacteria.
* **Avoid sexual contact while you have a urinary catheter.** Sexual contact can increase the risk of infection.

**Concerns about Bactrim**

Bactrim is a combination antibiotic that contains sulfamethoxazole and trimethoprim. The patient is allergic to sulfa, so she is at risk for an allergic reaction to Bactrim.

Other potential side effects of Bactrim include:

* Nausea and vomiting
* Diarrhea
* Abdominal pain
* Headache
* Rash
* Stevens-Johnson syndrome (a rare but serious allergic reaction)

The doctor will monitor the patient closely for any signs of an allergic reaction or other side effects.

**Conclusion**

Septic shock is a serious condition that requires prompt treatment. The patient will need to be admitted to the hospital for close monitoring and treatment. The doctor will order a variety of interventions, including fluid resuscitation, antibiotics, and vasopressors. The patient will also need to be taught about how to prevent infection.

The patient is at risk for an allergic reaction to Bactrim because she is allergic to sulfa. The doctor will monitor the patient closely for any signs of an allergic reaction or other side effects.