Question

1. Marie Perez, a 53-year-old patient, is day 1 after a gastric bypass. She complains of shortness of breath; her respiratory rate is 30 breaths/min, heart rate is 110 bpm, pulse oximetry 89% on room air, the temperature is 100°F, and her blood pressure is 90/50 mm Hg. She complains of feeling anxious and having stabbing chest pain which gets worse with inspiration. She complains that she feels like she is going to pass out or possibly die.

  

1. Discuss what could possibly be going on with the patient and what measures should the nurse provide immediately?
2. Discuss what risk factors does the patient have for a pulmonary embolus?
3. What measures are appropriate to manage a pulmonary embolism?
4. What measures are appropriate to help the patient in this case study prevent the reoccurrence of a pulmonary embolism?

Answer 1

1) Ans) a) measures should the nurse provide immediately

The patient complains of shortness of breath and has a high heart rate. She also complains of chest pain that is stabbing and it gets worse when she breathes in. these are some of the signs and symptoms of pulmonary embolism that is common after surgeries.
✓as a nurse she should inform the physician about patient condition
✓Changes in the vital signs of the patient and stabbing chest pain after one day
✓ of surgery may due to pulmonary embolism associated changes in the respiratory and cardiovascular system.
✓provide fowler's position
✓ Assess the patient by using cardiac monitoring

B. Risk factors does the patient having pulmonary embolism.

           * Age more than 50 years.

                 * Surgery ( Gastric bypass).

                 * Prolonged bed ridden status after surgery.

C. Measures to manage pulmonary embolism.

  * Anticoagulant treatment.
* Anticoagulants are blood thinners which help to prevent formation of blood clots or thrombus.
                          Eg; Warfarin,Heparin.
* Thrombolytic treatment.
* Thrombolytivs useful to remove blood clots by activating the natural fibrinolytic system which leads to lysis of blood clot or thrombus.
* Surgical treatment
* Surgical embolectomy - Surgical removal of embolus if the patient has mass pulmonary embolism.
* Transvenous catheter pulmonary embolectomy is also used to surgical   removing moving clots or emboli which block the pulmonary vessels circulation.

D. Measures to prevent the reoccurance of pulmonary embolism.

    ✓    Regular exercises to prevent clot formation.

     ✓  Avoid prolong sitting,standing and immobility.

  ✓ Feet should be place on floor and avoid crossing legs.

✓ Avoid use of constrictive clothings.

✓ Smoking causes changes in the coagulation mechanism of the body leads to formation of thrombus so do not use tobacco products.

✓ Use of compression stocking help to prevent formation of blood clots.

Could you please thumb up if answer was helpful ? thank you