Assessing Multi Organ Failure

Anna Bunting
Contemporary Nursing Issues
GNT1 - 724.2.1-01-08
October 25, 2011



















Rubric A: Assessment of Patient
The geriatric patient in multisystem failure presents many challenges to successful treatment. Differentiation between organ dysfunction and deterioration is often difficult to achieve. Also many typical signs of infection or sepsis that precipitate organ failure are masked or delayed in the elderly patient. It is important to recognize the physical and physiological differences in the geriatric population and take these into account when performing an assessment. Because all people age differently a thorough medical history is important in determining the patient’s baseline physical status and physiologic reserve. Immediate assessment of a patient’s homeostasis, oxygenation and pain level are critical for early diagnosis and treatment.
A preliminary physical assessment would include: vital signs, oxygen saturation, finger stick blood sugar, lung and bowel sounds, skin turgor and mucous membrane assessment and capillary refill to all extremities. Respiratory rate should be determined, keeping in mind that tachycardia and labored breathing are results of pulmonary dysfunction. Likewise lung sounds should be assessed for crackles/wheezes that indicate the presence of fluid in the lungs. Tachypnea is recognized as a sign/symptom of sepsis and Systemic Inflammatory Response Syndrome (SIRS). Multisystem failure usually develops as a result of SIRS, most commonly caused by infection, trauma, or major surgery. The pulmonary system is usually the first to show signs of failure from SIRS. Respiratory rate is a good indicator of the severity of dysfunction (Burdette, 2010). Pulse oximetry should also be monitored to measure the patient’s oxygenation. Temperature and pulse should be checked keeping in mind that both increase in the presence of infection and dehydration. Decreases in temperature and pulse may indicate...