On Tuesday March 24th, 2015 Mrs. Weil was admitted to the emergency room at 1300. Mrs. Weil is experiencing severe right hip pain after falling off her neighbour’s porch. Mrs. Weil is a 76-year-old Caucasian female who has a history of hypertension and osteoporosis. Mrs. Weil has a full resuscitation code for her medical directive and has no known allergies. Mrs. Weil is a widow who lives alone and has 3 children. Mrs. Weil’s vitals on admission are temperature 37.1 Celsius, blood pressure 124/80 mmol, pulse is 90 bpm, respirations are 16 bpm and her O2 saturations are 99% at room air. She rates her pain as five on the verbal numeric rating scale of one to ten. X-ray confirms that Mrs. Weil has a right sub capital hip fracture and is scheduled …show more content…
Mr. Weil’s blood pressure upon admission was 124/80 mmol, during her am assessment her blood pressure was low at 100/63 mmol, throughout the day her pulse and respiration were higher than normal range, refer to Appendix A for vitals within 24 hour period. Mrs. Weil has a history of hypertension, blood pressure is controlled by the amount of blood your heart pumps and the resistance the blood flow is in the arteries. Consequently any additional blood pumped in the heart narrows the arteries resulting in high blood pressure. Due to Mrs. Weil’s past medical history she is a high candidate for a pulmonary emboli, which is the blockage of a pulmonary artery. Mrs. Weil’s hemiarthroplasty surgery is a contributing factor since this increases the risks of forming new clots and possibly could have assisted in the development of a pulmonary emboli braced with her past history of …show more content…
The embolus not only precludes the exchange of oxygen and carbon dioxide, it can reduce blood supply to the lung tissue. Contributing factors that can impair the venous return and potentially create a pulmonary embolism would be a patient who is on prolonged bed rest, certain surgical procedures, overweight, family history and smoking. “Symptoms are nonspecific and include dyspnea, pleurisy chest pain, cough, and in severe cases, syncope or cardiorespiratory arrest. Signs are also nonspecific and may include tachypnea, tachycardia, hypotension, and a loud pulmonic component of the 2nd heart sound” (Newman, J., 2013). Common signs and symptoms of a pulmonary embolism are acute onset of shortness of breath, excessive perspiration, rapid heart rate, wheezing, weak pulse but rapid and chest pain that is similar to a myocardial infarction. Pain is located in the chest area and radiates to the shoulder, arm and neck. Mrs. Weil’s was complaining of sudden shortness of breath and chest pain. Throughout the day Mrs. Weil’s vitals were not within normal range, she had high shallow respirations of 30 bpm and her pulse was between 113 - 116 bpm and her lips were displaying slight cyanosis. Oxygen was then given and SaO2 was 98% on 35% FiO2. The etiology of most pulmonary embolisms is from thrombi in the lower extremities or pelvic vein. Pulmonary embolism’s can happen anywhere in the body, the most