Question

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, 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.

What risk factors does the patient have for a pulmonary embolus?

What measures are appropriate to manage a pulmonary embolism?

Answer 1

The major risk factor is surgery as result there is less physical mobilisation and increased the chance of clot formation and which thrombosed into lung causing pulmonary embolism

The appropriate measures to manage pulmonary embolism are

• Immediate administration of the anticoagulant to relieve or break the clot
• Monitor vital signs ,to plan care and to get baseline data
• direct thrombin inhibitor
• Xa inhibitor
• Vitamin K agonist
• DVT stocking to ensure lower limb circulation and thus preventing clot.