Question

if a patient has a total hip repacement surgery what is a path to death. Meaning what is the worst that can happen to the patient that can lead to death and how can you as a nurse prevent it. For example she can have a DVT and it can lead to a PE and cause death.

Answer 1

If a patient has a total hip replacement surgery, then one of the most serious medical complications is blood clots such as

1. Deep vein thrombosis (DVT): It refers to a blood clot in the leg and is called a deep vein thrombosis. A sudden increase in leg swelling along with calf tenderness may be the first sign of a blood clot in the leg.

2. Pulmonary embolus (PE): It refers to a clot that breaks off and travels to the lungs. Chest pain, an unusually fast heart rate or shortness of breath may indicate a pulmonary embolus.

Path to death due to PE:

In the second case pulmonary embolus (PE) the blockage i.e., a blood clot, prevents oxygen from reaching the tissues of the lungs. This means it can be life-threatening. In a pulmonary embolism, the blood clot forms in the surgeried hip, it circulates throughout the blood supply, and then it blocks the blood flowing through a vessel in another part of the body, namely the lungs which cmay cause death to the patient. The patient may feel chest pain, a sharp, stabbing pain that might become worse when breathing in, increased or irregular heartbeat, dizziness, difficulty catching breath, which may develop either suddenly or over time, rapid breathing, a cough, normally dry but possibly with blood, or blood and mucus.

Preventions and treatments of blood clots after hip replacement surgery:

a. Exercise/physical therapy beginning the first day after surgery and continuing for several months

b. Compression stockings

c. Anti-clotting medicine to reduce the body’s ability to form blood clots (Examples: Heparin, Warfarin, direct oral anticoagulants)