Question

You are caring for a patient who has had a RTHA yesterday. PMHx – MI 1998, DVT 1999, high cholesterol, hypertension, PE 2004 after flight to New Zealand.  Medications – Atrovostatin, Enalapril, ASA 81 mg, Diltiazem

1. What stands out to regarding this patient? What would this patient be at high risk for after their surgery?
   
2. If your patient said they had pain in their chest, what other questions would you ask.
   
3. You patient’s vitals are HR 115, BP 110/60, RR 24, temp 37.2, sat 88 on room air. What could be causing the tachycardia?
   

If your patient was on metoprolol and had the same vitals, except HR was 66. Would you be less concerned?

Answer 1

a.Complications after hip replacement

Risks associated with hip replacement surgery can include:

• Blood clots. Clots can form in your leg veins after surgery. So these blood clots could lead to a PE which could e life-threatening

b. Questions would be

• I would ask him the chest pain worsens when he tries to breathe.
• Are you feeling light-headed?
• Do you feel like you are sweating a lot?

c. The fact that the heart rate has come down to a normal range is a good thing. But still, to be on the safer side I would diagnose the patient for a pe. Since his pulse is very low. I would order some tests such as a chest X-ray or an ultrasound scan to see if you have a blood clot in your leg, and tests to check how well your lungs are working.