Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

A. This type of shock occurs when there is widespread vasodilation leading to a relative hypovolemia, often seen in conditions like sepsis. Given that the patient has a surgical site infection, this is a plausible consideration. However, distributive shock typically involves more than just hypotension, including symptoms like warm skin and possible fever.
B. This type of shock results from significant fluid loss, leading to inadequate circulating volume. It can occur after surgery due to bleeding or fluid loss, but the context here suggests that the primary issue is infection rather than direct fluid loss.
C. Obstructive shock happens when there is a physical obstruction to blood flow, such as in cases of pulmonary embolism or tension pneumothorax. There’s no indication of obstruction in this scenario related to the infection and hypotension.
D. This shock type occurs when the heart fails to pump effectively, often due to myocardial infarction or severe heart failure. The patient’s history does not suggest heart dysfunction, so this option is less likely.

A. Aging can lead to changes in immune function, including alterations in white blood cell counts. While absolute counts may not be drastically lower, the immune response may be less effective. This is important information as it helps the patient understand their altered immune status and potential infection risks.
B. Older adults may have a diminished immune response, which can lead to false-negative results in tuberculosis skin tests (e.g., PPD test). This is crucial information, as it can affect diagnosis and treatment decisions, highlighting the need for alternative screening methods.
C. Vaccinations are critical for older adults to help prevent infections. Influenza, pneumococcal, and shingles vaccines can significantly reduce the risk of these infections, which are more severe in the elderly. This is an essential component of their health maintenance.
D. Older adults are at increased risk for respiratory tract infections (like pneumonia) and genitourinary infections (like urinary tract infections) due to factors such as comorbidities and changes in immune function. Educating clients about these risks helps them recognize symptoms and seek timely care.
E. Older adults often require booster vaccinations to maintain immunity, as their immune response may diminish over time. This misinformation could lead to increased susceptibility to vaccine-preventable diseases.
F. It is common for elderly individuals to present with atypical signs of infection, including the absence of fever even in severe cases. This is important for both the patient and caregivers to understand, as it may lead to delayed recognition and treatment of infections.