PQRST Pain Assessment

PQRST Pain Assessment
Femur fractures have the potential to cause dangerous complications such as blood clots to develop
in the large veins of the thigh, blood clots moving through the blood stream will result in obstruction
in the lungs thus forming a condition called pulmonary embolism, ("Leg Fracture Guide: Causes,
Symptoms and Treatment Options", 2017), which this male patient is most likely experiencing and
developing. The nursing care and immediate actions I would provide for a patient with a fractured
femur presenting with shortness of breath and chest pain, would be to perform an accurate and
thorough nursing assessment as well as a systemic observation to gain an understanding of this
patients presentation. For example, recording and observing the respiration ... Show more content on
Helpwriting.net ...
The cause of Mrs Walters not having her blood glucose levels reviewed is alarming as she may
become hyperglycaemic resulting in inadequate amount of insulin to glucose thus, developing
diabetic ketoacidosis. Stabilization of the fasting blood glucose reduces insulin resistance
significantly reducing the risk of complications (Sheehan, 2004). However, inadequate blood
glucose control over an extended period of time can result in significant continuing problems, such
as complications of numerous organ systems, including the eyes, kidneys and nerves. Therefore,
Mrs Walters requires an immediate blood sugar level reading prior to eating.
Mrs Peterson would be my third care priority as she has recently had a stroke and is classified as a
high falls risk. Falling is the greatest common complication of stroke patients as Mrs Peterson is
predisposed to falls, (Shim, Yu, Jung, Kang, & Cho, 2012; Cho, & Lee, 2013). Mrs Peterson's result
in possibly falling may lead to a reduction of independence of activities of daily livings (ADL's),
and conceivably secondary injuries. Assisting Mrs Peterson to use her bowels will dramatically
decrease the negative healthcare outcomes which may arise if she is not attended too
... Get more on HelpWriting.net ...

Essay On Pulmonary Embolism
Various studies has been presented many methods to prevent pulmonary embolism in high–risk
patents which mostly focus on using of inferior vena cava filters, and anticoagulation. However,
contradictory results are suggested within this research because only a certain type of inferior vena
cava filters are examined, for example, prophylactic inferior vena cava filters. Dazley et al. (2012)
shows the efficacy of propyl lactic IVC filters in preventing the development of venous
thromboembolic event in patients undergoing surgery, while the other study proposes the different
result. To understand how IVC filters and anticoagulation effect on high–risk patients. This paper
study Dazley et al.'s (2012) research to express better understand how ... Show more content on
Helpwriting.net ...
Small embolism that stuck in the peripheral branches of the pulmonary artery are clinically silent
and may go unrecognized. People with moderate–sized emboli often present with breathlessness
accompanied by pleuritic pain, apprehension, slight fever, and cough productive of blood–streaked
sputum. Patients with massive emboli frequently specific with sudden collapse, crushing substernal
chest pain, shock, sometimes loss of consciousness; so massive emboli often are mortal (Porth,
2011).
Spinal cord injury is the serous risk that cause VTEs and lead to PE, so Dazley et al. (2012) research
concentrations on the efficiency of prophylactic IVC filters PE in patients undergoing major spinal
injury to prevent PE. Pulmonary embolism has been present in up to 12% of patients undergoing
spine surgery and 2% fatal rate (Dazley et al., 2012); therefore, patients diagnosed with PE require
prompt and aggressive treatment with anticoagulation such as low–dose heparin and low molecular–
weight heparin. However, the anticoagulation pharmacologic agent can cause bleeding problems, up
to 67% (Dazley et al., 2012), and the most bleeding complication in spinal cord surgery is
compressive epidural hematomas; therefore, the bleeding complications become worst in patients
who cannot be treated with anticoagulation. Their effects require immediate surgical intervention
and still may leave patients with permanent neurological deficits in as many as 37.5% of patients
((Dazley et

Massive Pulmonary Embolism: A Case Study
Several studies have demonstrated use of tPA in massive or sub–massive pulmonary embolism to
accelerate lysis of thrombi in patients presenting with sustained right ventricular dysfunction or
circulatory collapse. Even though systemic tPA is the mainstay therapy, catheter directed techniques
can also be employed in patients in severely critical condition or who have significant bleeding risk.
A 41–year–old male arrived at Augusta University Medical Emergency room after a motorcycle
collision with ejection. Upon arrival, patient was hemodynamically unstable and after resuscitation
was taken to operating room as level one exploratory laparotomy. In the OR, the patient was found
to have a large retroperitoneal hematoma due to right renal vein injury – ligation and right
nephrectomy were performed. Patient continued to have a tenuous course throughout the next day,
requiring nephrology consults, selective embolization of several second and third order hypogastric
arteries bilaterally. Patient returned to shock ... Show more content on Helpwriting.net ...
Most common presenting signs are dyspnea at rest, pleuritic pain, cough and orthopnea. Upon initial
presentation of PE hemodynamic status should be assessed based and patients should be strafed into
low risk, moderate or high risk. Majority of patients with PE are hemodynamically stable. Roughly
8% of the patient's present with hemodynamic instability and circulatory collapse. These patient
have either systolic blood pressure 15 minutes, hypotension requiring vasopressors or clear evidence
of shock. However, there are a few patients who are hemodynamically stable but have significant
ventricular dysfunction and borderline SBP due to extensive clot burden – these patients are
characterized as intermediate risk or

Amniotic Fluid Embolism
What is An Amniotic Fluid Embolism?
An amniotic fluid embolism is a rare complication that occurs during delivery or pregnancy. It
occurs when amniotic fluid enters the mother's circulatory system. It is estimated that an amniotic
fluid embolism occurs anywhere from 1 in 8,000 to 1 in 80,000 deliveries. Even though this
condition is rare, it is serious.
An amniotic fluid embolism can cause a woman to go into cardiac arrest. It can also cause her to
hemorrhage.
Causes Of An Amniotic Fluid Embolism
Researchers do not know exactly what causes an amniotic fluid embolism. However, they do believe
that a ruptured uterus, ruptured membranes and a pressure gradient from vein to uterus can increase
the risk of this condition. There has also been

Pulmonary Embolism Research Paper
A pulmonary embolism is a blockage that is located in the lung artery. The cause is more than likely
to come from a blood clot in the leg called a deep vein thrombosis. When that happen it breaks loose
and travels throughout the blood stream and into the lung which cases the pulmonary embolism.
When that happens is causes permanent damage to the lung that was affected, low oxygen levels in
your blood and damage to any other organ in your body that isn't getting the sufficient amount of
oxygen it needs to run properly. In some cases if the clot is large enough the pulmonary embolism
may cause death. Some people who have these embolisms have no symptoms. Those who do have
symptoms would include of having shortness of breath, coughing up blood or chest pain. Symptoms
of the blood clot portion would include warmth, pain, swelling, tenderness and redness of the leg it
is occurring in. the main goal of treatment is to disperse of the blood clot an prevent new ones from
forming. The risk factors for a pulmonary embolism are the same as the risk factors for deep vein
thrombosis. These are referred to as ... Show more content on Helpwriting.net ...
A pulmonary anagram are very rare while testing these days but it was where dye was injected and a
clot or clots could be identified on imaging studies. This is considered an invasive test. A CT scan of
the chest with angiography can be done. Contrast material (dye) is injected into an intravenous line
in the arm while the CT is being taken, and the pulmonary arteries can be visualized. There are some
limitations of the test, especially if a pulmonary embolism involves the smaller arteries in the lung it
is very important that the contrast material used during the CT angiogram be timed appropriately so
that the bolus of dye is not diluted as it travels through the

Stroke: The Fourt Leading Cause of Death in the United...
Introduction
Stroke is the fourth leading cause of death in the United States. Each year more than 795,000
Americans suffer from a stroke, which means that every forty seconds someone has stroke
(Liebman, 2012). Although a stroke can occur at any age, strokes are frequently seen in the older
adult demographics. An increase with age doubles the risk for a stroke each decade after 55
(Grysiewicz, 2008). The percentage of stroke survivors to almost fully recover from a stroke is only
10 percent; in contrast, 40 percent of stroke survivors will face moderate to severe impairment
which will entail distinctive care (Perlmutter and Colman, 2005). When all strokes are analyzed
according to demography of class system, approximately 60% of strokes occur in low or middle
income countries (Silverman and Rymer, 2009). Often times, doctors will typically call a stroke a
"brain attack" because the events that transpire resemble those that occur during a heart attack
(Wang and Aamodt, 2010). Blood supplies a constant source of oxygen to the brain. However, a
stroke occurs when that blood supply to any given part of the brain is suddenly ceased. If the blood
supply to the brain is suddenly interrupted this leads to the deprivation of oxygen and glucose to that
area. The brain cells that are prevented from acquiring these substances, especially oxygen, will be
quickly killed off. Strokes can be categorized into two classes: Ischemic and hemorrhagic strokes
(Lindley, 2008). Stroke

Case Study: An Extended Stay
In the health care system, a multitude of errors occurs on a daily basis. Doctors, nurses, orderly's,
etc., everyone in health care settings has responsibilities that warrant careful attention. This was
exhibited in the case study titled 'An Extended Stay'. In this case study, we are introduced to a
middle–aged man in his 60s named Mr. Stanley Londborg. He presented with several health
conditions, including a seizure disorder, hypertension (also known as high blood pressure), and
Chronic Obstructive Pulmonary Disease (COPD). Londborg was no stranger to the hospital and was
known fairly well by faculty members. Londborg paid a visit to the Emergency Room at the hospital
complaining of wheezing and breathing complications. The physician that examined Mr. Londborg
yielded his symptoms as an acute worsening of ... Show more content on Helpwriting.net ...
This can be read as a key ethical question to many healthcare case studies because of the errors and
situations that occur. One of the explanations for this occurrence may be the overwhelming
workload, chaotic environment and lack of individual attention prescribed to each patient. These
issues can cause a disruption to the ethical principle of Beneficence. The principle of Beneficence
calls to action the act of helping others and having compassion for the patients. This principle can be
threatened when a doctor or caretaker is overworked and unable to effectively manage the series of
patients and work they are assigned to take on. I believe that the admitting doctor did not initially
catch the error of not calling for the specific drug need because he was more focused on getting Mr.
Londborg stable and on the medication to treat his initial and present condition before worrying
about the preventative medication. In addition, the doctor was so focused on helping everyone all at
once that he was blind to the small details and loose ends that needed to be taken care

Common Category Of Cardiac Arrhythmias
Introduction
Atrial Fibrillation
Atrial Fibrillation (AF) known to be the common category of cardiac arrhythmias. It is mainly due
to the rate or rhythm abnormalities of the heart and is a type of 'supraventricular tachycardia' (SVT).
Rapid and irregular heart beating is a characteristic sign of atrial fibrillation. It is of significance
since it a high risk of leading to thromboembolic events, heart failure and mortality (1).
The prevalence of atrial fibrillation globally has increased significantly to about 2–3% in the
population. Since the risk of atrial fibrillation increases significantly with age, due to multiple co–
morbidities, the UK's increasing elderly population has a marked increase in incidences of atrial
fibrillation (2).
Complications
Patients with on–going atrial fibrillation have been shown to have an increased risk of
thromboembolic events. The clots that can be formed in the heart during atrial fibrillation can easily
travel and obstruct blood vessels, leading to tissue ischemia, thus causing severe organ damage such
as a Pulmonary Embolus or stoke. It is highly recommend that patients with atrial fibrillation
undergo anticoagulation therapy with drugs that help thin the blood such as Warfarin to help prevent
clot formation. These drugs come with serious side effects such bleeding in the brain that can lead to
complications or even death.
Treatments methods
Since 1954 Warfarin, a vitamin K antagonist (VKAs) has been the Gold standard anticoagulant

Air Embolism: Endovascular Procedure
Air embolism
Introduction
Air embolism is a rare but potentially serious complication of endovascular procedures, and can
involve both the venous and arterial systems. The risk is higher in procedures where there is low or
negative intravascular pressure; in these situations, bleeding is less likely to occur, and so air may
instead enter the vessel. If air travels to a distant organ where there is insufficient collateral supply,
ischemia or infarction may occur.
We review air embolism in the context of interventional radiology, although air embolism can also
occur with barotrauma, lung biopsies and during surgical procedures, most notably neurosurgery
and cardiothoracic surgery. In the former, patients may be operated on in the upright position, ...
Show more content on Helpwriting.net ...
In those patients under anesthesia, reduced end–tidal CO2 may be noted as the earliest indicator of
air embolus. Additionally, the anesthesiologist may also note reduced oxygen saturations.
Importantly, reduced oxygen saturation on pulse oximetry is considered a late sign of vascular air
embolism [7].Many radiologists may never see a case of symptomatic air embolus in their careers,
and so understanding the pathophysiology and treatment is important.
The neurological signs and symptoms may be related to direct passage of venous air across a patent
foramen ovale or related to reduced cardiac output and associated cerebral hypoperfusion[7]
Two key factors which determine the outcome of vascular air embolism are the rate and volume of
air accumulation[7]. Animal studies have been performed to estimate the volume of air required to
produce lethal circulatory arrest, with case reports suggesting the lethal dose of air in adults is
between 200 and 300 cc, or 3 – 5 ml/kg[7, 11, 12]. Although at first glance, one may consider this a
very large amount of air that would not easily be introduced to the vascular system, it has been
shown that a 14 gauge needle can transmit 100 cc or air per second with a pressure gradient of 5 cm
H20. A 15 French (5 mm diameter) peel–away sheath used during placement of a tunneled
hemodialysis catheter can allow 300 cc

Cerebral Air Embolism Following Pigtail Catheter Insertion
Cerebral air embolism following pigtail catheter insertion
Abstract:
Pleural pigtail catheter placement associated with many complications including pneumothorax,
hemorrhage, and chest pain. Air embolism can rarely be a complication of pigtail catheter insertion
and has a high risk of occurrence with positive pressure ventilation (PPV).
Cerebral air embolism is a very rare complication but lethal. We report a case of patient of cerebral
air embolism as a complication of placement of pigtail pleural catheter placement while a patient on
(PPV).
Case presentation:
A 50 years old male who has bilateral pneumonia, was found to have pneumothorax while on
mechanical ventilation CPAP/PS mode. While placing the pigtail catheter, the patient ... Show more
content on Helpwriting.net ...
Keywords:
Cerebral air embolism–Pigtail catheter–Pneumothorax– Chest Tube
Introduction:
Placement of a chest tube indicated for pleural effusion and pneumothorax. There have been two
kinds of chest tubes being used, including a Pigtail catheter and chest tube thoracotomy.
The pigtail catheter drainage is widely used as it is easier and less invasive
Cerebral air embolism is a rare complication that can be induced by pulmonary barotrauma, the
trauma of the chest or head and iatrogenic causes such as invasive procedures or surgery. This risk
increases if the patient is on positive pressure ventilation and while the pressure in the airway
increased.
We reporting a case of cerebral air embolism associated with pigtail catheter insertion for treatment
of pneumothorax in a patient who was on positive pressure mechanical ventilation.
Case Report:
This is a 50 years old male with no significant past medical history presented initially with shortness
of breath and hypoxia and was transferred to the ICU. He was treated for bilateral pneumonia that
required prolonged mechanical ventilation via a tracheostomy. He has necrotizing pneumonia and he
has been in the hospital for 6 weeks due to the development of multi–organ failure. He was weaned
from mechanical ventilation to the point he was tolerating a CPAP/PS mode. Later on, it was noticed
that he

Characteristics Of A Nurse
The Oxford English Dictionary defines a nurse as, "A person trained to care for the sick or infirm,
especially in a hospital." However, this is not my definition of a nurse. My idea of a nurse relates to
a superhero, aiding in the healing of a body. A nurse is a champion who comes into work with
energy, patience, aching feet, stained scrubs with sweat from a strenuous day at work but always a
smile. A nurse goes home 12 hours later from their shift only to remember the extra blanket for Jody
and also that is not sweat on my clothing, it is urine, but a nurse is thrilled that Phil finally went to
restroom after a ten–minute story about 10 cent candies. Not just any person could care for Jody,
who requests three blankets each night or Phil who refuses to utilize the restroom, but a superhero
could, a nurse could. I yearn to be a nurse; to be a superhero. Two exceptional qualities come to
mind when I regard a nurse, kindness and patience. Kindness for Jody, who will wake up in two
hours requesting less blankets because she is too hot, despite the fact this is a repeat of the exact
events from the day before. Patience for Phil for the reason that you told him he should try to visit
the restroom before dinner, but before long and he is explaining how to build a computer. Two
exceptional qualities I claim to express, every time I am on the job. My employment is in a long–
term care facility as a Certified Nursing Assistant, every day is a new adventure; maybe today I can

Pulmonary Embolism: A Case Study
Pulmonary Embolism
Pulmonary embolism is described to be the "sudden blockage of a major blood vessel artery in the
lung" (WebMD, 2014) which can usually be caused by a blood clot. The most common factor of
pulmonary embolism is blood clots breaking loose from the leg and traveling to the lungs.
Unfortunately, having pulmonary embolism can be fatal due to a large clot stopping blood flow
going into the lung.
According to the Centers for Disease Control and Prevention statistics, "the precise number of
people affected by pulmonary embolism is unknown." There is a shocking rate of 900,000 people
who can be affected by a pulmonary embolism, making it 1 to 2 per 1,000 people each year in the
United States alone. The overall estimate suggests that 60,000–100,000 Americans die of pulmonary
embolism, 10 to 30% within one month of diagnosis. (Centers for Disease Control and Prevention,
2015)
Immediate attention and scheduling an appointment with your primary care physician is needed if
you are experiencing these symptoms:
Sudden shortness of breath
Sharp chest pain that worsens when you cough or are taking a deep breath
A cough that brings up pink, foamy mucus
Feeling of anxiousness or on edge ... Show more content on Helpwriting.net ...
If an aggressive treatment is needed, it may require thrombolytic medicines, which help to dissolve
the blood clot rapidly. There are benefits from taking thrombolytic medicine but on the down side it
can increase the risk of severe bleeding. Another form of treatment is to have an embolectomy
performed through surgery or minimally invasive procedure. "Having a vena cava filter inserted into
the large central vein of the body" (WebMD, 2014) has also resulted in being very beneficial to
patients. The filter helps prevent blood clots from reaching the lungs and normally used as a
resource for patients who cannot take any

Pulmonary Embolism Essay
According to new research by Japan's Osaka University, binge watching sessions increase a person's
chance of receiving a fatal pulmonary embolism.
Binge–watchers could be putting themselves in danger by watching entire seasons of TV shows in
one sitting. Those who watched at least five hours of television everyday have more than double the
risk that a person who watches two and a half hours or else has of a fatal pulmonary embolism.
According to WebMD, a pulmonary embolism is a blood clot that completely stop blood flow and
immediately kill the person suffering from it.
THE INCREASE IN RISK
At the European Society of Cardiology's annual conference in London, the research was revealed. A
press release by the organization noted that the link was strongest in people less than 60 years old
watching more than five hours of television a day. For ... Show more content on Helpwriting.net ...
Toru Shirakawa of Osaka University, the project's lead researcher, said in a statement.
"Leg immobility during television viewing may in part explain the finding."
The study, which was funded by the Japanese government, is the first ever to research a link
between fatal pulmonary embolisms and watching television for long periods of time according to
Independent Online.
POPULARITY OF BINGE–WATCHING
According to the Los Angeles Times, a Deloitte LLP survey about binge–watching found that 68%
polled said they had binge–watched before, with 31% saying that they had did so at least once a
week. In response, the newspaper has called binge–watching "the dominant mode of TV
consumption in the US".
HOW THE STUDY WAS DONE
Researchers at Osaka studied 86,000 people over an 18–year period, and calculated health risk after
adjusting it to take into account factors like body mass index, menopausal status, smoking, diabetes
or hypertension, The Independent pointed out.
UNKNOWN WHETHER SAME CONNECTION EXISTS WITH SMARTPHONE

Pulmonary Embolism Paper
Pulmonary Embolism Outcomes and Pathophysiology Pulmonary embolism, what is it and how are
the outcomes for this disease process and why is this disease so very important to treat as soon as
possible? Well according to Medline Plus pulmonary embolism are essentially blot clots that get into
the arteries of the lungs and cause a blockage which can lead to many serious problems if not treated
correctly. The type of clot that is usually attributed to this disease is one that comes from deep vein
thrombosis which often comes from one of the lower legs. Pulmonary Embolism: Medline Plus
(2016, March 15). The lungs are a very important part of the body as important in the process
cellular respiration, which with the lungs take the carbon dioxide ... Show more content on
Helpwriting.net ...
Now it is easier to treat the disease with the newer medications that are available and better
procedures that can be performed with lower risks. The outcome for this disease today is a higher
rate of survival and lower risk of complications. With a study that was conducted from 2001 to 2007
they determined that 70% of participants in the study were free of any recurring problems after the
first year at the end of the study. After two years the rate dropped to 60% and then four years after
the end of the study it was concluded to be less than 50 percent were free of any problems. Klok, F.
A., & Zondag, W. (2010). This outcome can be attributed to many factors such as diet and exercise
which are necessary to help prevent blood clots. After the treatments and therapies for the
pulmonary embolism a certain percent of those treated my redevelop a pulmonary embolism for
unknown reasons that are still being studied in clinical trials being conducted to this day. The
general prognosis for pulmonary embolisms is good with the rate of recurrence being less than 5
percent if a person is on anticoagulant

The Emergency Room Physician Ordered The Following Test Essay
A sixty two year old Caucasian male presented himself to NEA Baptist Medical Centers Emergency
Department on 9/8/16 with chest pain and worsening of shortness of breath. On 9/6/16 the patient
had a bilateral saddle embolism (a large pulmonary thrombo–embolism that straddles the main
pulmonary arterial trunk at its bifurcation) for which he had an embolectomy where he made a full
recovery and discharged with Eliquis. Eliquis is an anticoagulant drug used to treat of venous
thromboembolic events. The patient reported that he had been coughing over the past couple of days
a little bit more than usual. The patient did admit that he had a few episodes of hemoptysis, but
denied any massive hemoptysis. On arrival to the emergency department the patient was in mild to
moderate respiratory distress. Physical Examination: BP 80/51, Pulse 144, Respiration 49, and
Height 5'10, Weight 93.44kg (206lb) the emergency room physician ordered the following test:
CBC: Hgb 14.4; Hct 42.1; WBC 0.4(L);RBC 4.59, Aterial blood gas: FI02 .44; pH of 7.38, PO2 97,
PCO2 31 and HCO3 21.3 showed hypoxemia persisting and slightly alkaline, with decreased pCO2
of 31, suggesting some level of hyperventilation. EKG revealed sinus tachycardia and no specific S–
T–T wave. CXR revealed bibasilar alteletasis. No pneumothorax or significant pleural effusion. The
patient had initially been started on a bi–nasal cannula on 6L/min, but patient was not able to get O2
up so physician ordered a Bipap. While the patient

A Silent Killer : Pulmonary Embolism A Silent Killer
Pulmonary Embolism a Silent killer
Pulmonary Embolism is a life–threatening condition that has most serious manifestation of venous
thromboembolism that is leading cause of sudden death. "With massive pulmonary embolism (PE)
being the first or second leading cause of unexpected death in adults, protection against PE is critical
in appropriately selected patients" (Georgiou, Katz, Ganson, Eng, & Hon, 2015). How does this
effect the nursing? If Pulmonary embolism is suspected, nurses goal is to halt PE that is forming a
clot and from embolizing. Nurses must be extra diligent in preventing Pulmonary embolism, be able
to recognize it early, provide prompt help and start appropriate treatment because if it is
unrecognized or untreated it can cause death very quickly. Knowing how to intervene when PE is
suspected can make a difference in life a threatening emergency. "Massive PE, defined as causing
50% or more occlusion of the pulmonary capillary bed, can result in obstructive shock with systemic
hypoperfusion (low cardiac output and acute pulmonary hypertension with right ventricular failure).
ANA''.
Pathophysiology of PE
A Pulmonary Embolism is usually caused by a blood clot (thrombus) that migrates from its original
site to occlude a distal vessel. Normally, human body lyses the thrombi that was formed within the
circulatory system, but if the clot not fibrinolyzed, it may break off and can travel with a
deoxygenated blood to the heart and goes in the lungs by obstructing the

Venous Thromboembolism And Pulmonary Embolism
Venous Thromboembolism
Venous thromboembolism (VTE), including both deep venous thrombosis (DVT) and pulmonary
embolism (PE), is reognised as the leading cause of preventable in–hospital mortality. DVT is the
formation of blood clots in a deep vein– usually the large veins in the leg or pelvis. The most serious
complication of a DVT is that the clot could dislodge and travel to the lungs, becoming a life–
threatening blood clot in the lungs, pulmonary embolism. When a blood clot breaks loose and
travels in the blood, this is called a venous thromboembolism. An inflammatory reaction is usually
present mainly in the superficial veins and, for this reason this pathology is often called
thrombophlebitis. It is a disorder that can occur in all races and ethnicities, all age groups, and both
genders. Despite a marked increase in federal and national efforts to raise awareness and
acknowledge the need for VTE prevention, VTE continues to remain as an important and growing
public health problem. Unfortunately, VTE recurs frequently and is commonly overlooked, affects
both hospitalized and non–hospitalized patients, and results in long–term complications including
chronic thromboembolic pulmonary hypertension (CTPH) and the post–thrombotic syndrome
(PTS).
Venous thrombi, composed predominately of red blood cells but also platelets and leukocytes bound
together by fibrin, form in sites of vessel damage and areas of stagnant blood flow such as the valve
pockets of the deep veins of

The Clinical Picture of Acute Pulmonary Embolism
Introduction The clinical picture of acute pulmonary embolism (PE) is not similar from various
aspect of its pathophysiological course presenting from minimal symptoms to variety of severity of
disease like severe hypoxia, hypotension, right heart failure and death1. Massive pulmonary
embolism is defined as obstruction of blood flow to a lobe or multiple segments of the lung, or for
unstable hemodynamics, i.e. failure to maintain blood pressure without supportive measures." This
case highlights about aggressiveness of treatment and role of thrombolytic therapy for a severely
hemodynamic unstable patient2. Case report In February 2013, a forty–eight years old male with no
prior co–morbidities transferred from Quetta to Aga Khan University Hospital, Karachi after
sustaining multiple lacerations and left tibia bone closed fracture in a bomb blast. After initial
management in the hospital, he underwent an orthopedic procedure (application of illiazarov over
left tibia) under general anaesthesia. The surgery went uneventful, and he then shifted to ward. From
next day morning, he suddenly developed dyspnea and became hypotensive and tachycardiac
(respiratory rate about 40/min, pulse 140 beats per min and blood pressures were around 60/30). He
was barely maintaining oxygen saturation 90% on 10 liters of O2 via facemask. Initially, he was
given 2 liters of fluid bolus but hemodynamics did not respond. A few minutes later, he went into
pulseless electrical activity and

Accountability of Nurses
ACCOUNTABILITY OF NURSING PROFESSIONALS Jayamole Cherian NRS 430V August, 20,
2001 Melissa Pasqua Accountability and Concepts Accountability means that somebody is able to
explain or answerable for their actions, whatever the consequences are regardless of success or
failure. Accountability and responsibility are not synonymous but related, accountability incorporate
with the concept of responsibility which means to account for what has been done. Delhmer's 2006a,
p. 46). Accountability for an outcome usually concentrated on 'who' and responsibility ... Show more
content on Helpwriting.net ...
According to Baystate Medical Center, they could reduce postoperative deep vein thrombosis (by
55percent) after the implementation and adherence to evidence based protocol. We have to assess
the client for any risk through their history. Close observation is important of who is at high risk,
and who have signs and symptoms. Prophylaxis and follow up evaluation should initiate in those
who are at risk. Physical signs are not always dependable, according to National Heart, Lung and
Blood Institute, only 50% of them has symptoms. In my unit, we do a thorough teaching about
DVT, and observe very closely. If there are any symptoms, then we do an ultra sonogram. Current
evidence strongly recommends doing a D–dimer assay if there is any suspicion. Positive D–dimer
shows that there has been a thrombus and breakdown in the body. CT venography help to see any
clots distal to inguinal ligament.MRI is more accurate than any of these tests. Nursing interventions
which we does on our floor is early ambulation, frequent assessment, proper communication with
other health team members, use of Sequential Compression Device and Foot Pump, it is an evidence
based guidelines for prevention (Kehl–Pruett W., (2007). Most of the patients tolerate it well,
sometimes they complaints of feeling warm and sweaty, and can't go to sleep. Those who do not get
appropriate prophylactic treatment,

Research Paper On Pulmonary Embolism
Pulmonary Embolism
4/19/16
Health and Illness 1
Shayna, Amanda, Whitney, Samantha Concept Overview Pulmonary embolism is defined as a blood
clot or blockage in the lungs. A pulmonary embolism can be small or massive. Either small or
massive can cause serious complications in an individual. Breathlessness, chest pain, coughing up
blood (hemoptysis), a mildly raised body temperature, tachycardia, and sometimes no symptoms at
all are all acute symptoms of a pulmonary embolism. Severe breathlessness, chest pain, feeling faint,
and some cases cardiac arrest are all symptoms of a chronic pulmonary embolism (Hartree, 2014).
Pathophysiology
A pulmonary embolism (PE) is a collection of particulate matter that enters venous circulation and
... Show more content on Helpwriting.net ...
A pulmonary embolism occurs when a clot breaks off somewhere in the body and travels to the
lungs causing a blockage (2016). If a pulmonary embolism is caught early enough, it can be treated
with medications known as "clot busters." If the pulmonary embolism is not found early enough, it
can lead to a severe complication of damaging the lungs or even death (2016). People who have
blood clots or who have blood clots in the past are always at future risk for developing a pulmonary
embolism.
Diagnostic Testing
1. Chest X–ray: Though not used for diagnosis, can show signs of conditions that resemble PE.
2. Ultrasound: Used to find clots within the vascular system
3. CT–Scan: Used to detect abnormalities in the arteries of lungs
4. Pulmonary Angiogram: Much like a cardiac catheterization, a catheter is threaded through a large
vein, like in the groin and into the pulmonary veins. A dye is then injected to identify any
threatening obstructions. While the dye is injected x–rays are taken to find and pinpoint the embolus
(Ignatavicius, Workman, Blair, Rebar, &

Deep Vein Thrombosis
|Deep Vein Thrombosis |
| |
|Anatomy and Physiology 11 |
| |
|4/13/2010 |
| |
|Patricia Libby | ... Show more content on Helpwriting.net ...
A history of the patient must be taken to observe any risk factors such as, the use of estrogen–
containing methods of hormonal contraception, also including, a recent long haul flying, intravenous
drug use, or any history of miscarriage. Miscarriage is just one feature of several disorders causing
thrombosis. The risk of DVT is higher (in real long haul flying), in travelers who smoke, are obese,
or are currently taking contraceptive pills. Hereditary factor may also be a contributor in the
development of DVT. This is why a family history should be done. Along with the fact about 35%
of DVT patients have at least on hereditary disorder which promotes excessive blood clotting.
DVT can develop by lying in bed for long periods of time. Therefore, hospitalized patients have a
considerably higher incidence of DVT. It varies from 20% to about 70%. (cdc.gov). Venous
ulceration and venous insufficiency of a person's lower leg, which are long term complications of
DVT affect five tenth of a percent of the entire population.
Prevention of DVT is advised in many medical and surgical inpatients by using anticoagulants,
graduated compression stockings or intermittent pneumatic compression devices, (also known as
thromboembolic deterrent stockings). Anticoagulation is the usual treatment for DVT. As a rule,
patients are put on a brief course, (less than a week), of Heparin treatment, while starting a 3 to 6
month course of Warfarin (or related Vitamin K

A Nurse's Perspective on the Alert for Pulmonary Arterial...
On The Alert for Pulmonary Arterial Hypertension
On The Alert for Pulmonary Arterial Hypertension
Summarized by: Joanne Marie Tarrobal–Baynosa
Arellano University – INP
Summarized by: Joanne Marie Tarrobal–Baynosa
Arellano University – INP
By Vincent M. Vacca, Jr., RN, CCRN, MSN
Nursing Journal, December 2009 Issue
By Vincent M. Vacca, Jr., RN, CCRN, MSN
Nursing Journal, December 2009 Issue
Nurse Vincent M. Vacca, Jr. aptly described in this issue of the Nursing Journal the significance of
early detection and health management of people who are or are maybe suffering from Pulmonary
Arterial Hypertension. He described PAH as a condition wherein a patient is having a mean
pulmonary arterial (PA) pressure of greater than 25 mm ... Show more content on Helpwriting.net ...
A lung or heart transplant is then recommended for patients whose condition doesn't improve or
worsens. The survival rate according to nurse Vacca for patients receiving lung transplant is 74%
after 1 year and 45% after 5 years of receiving the new lung. However, he said the wait time for
donor lung can take up to 3 years but sadly patients with PAH can not wait that long. Therefore
nurse Vacca emphasized the importance of educating families and patients with PAH the proper
management of this condition in order for patients to live longer and have a better quality of life.
Some of the examples he mentioned in the proper management of this condition includes proper
administration of medication including knowing its side effects, appropriate planning of activities
and rest, reducing fluid retention by following a low sodium diet, daily weight monitoring and being
alert in recognizing peripheral edema, the use of supplemental oxygen if needed, and knowing when
to contact a health care provider upon onset of symptoms. Most importantly, encourage patients to
discuss end of life issues with their family and/or social services and support

Questions On The Practice At A Semester II Level
Current review for VTE prophylaxis
Shubhreet Malhi
300192775
Table of Contents
Introduction.....................................................................................................3
Analysis and Synthesis.......................................................................................4
Implications to the practice at a semester II level.........................................................6
Impact on the nursing care and or health care.............................................................8
Conclusion....................................................................................................10
References.....................................................................................................11
Appendix A: Matrix Table...................................................................................3
Current review of VTE prophylaxis
INTRODUCTION
Throughout the surgery, numerous complications arise despite the proper planning. Perhaps, one of
the most dangerous complication is the Venous Thromboembolism (VTE) – a broad concept which
encompasses Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). The risk for VTE after
surgery is further increased and in absence of thromboprophylaxis, it is associated with high
mortality rate of 40–60% (Liu et al., 2016). Hence, VTE prophylaxis guidelines recommends the use
of pharmacological prophylaxis such as warfarin, low molecular weight heparin (LMWH).
However, the chemical therapeutic agents are associated with increased risk of bleeding,
intraoperative hemorrhage and hematoma (Frostick, 2016). This further results in delayed wound
healing, infection and high risk of readmission (Nam et al., 2015). Therefore, this paper explores is
the cooperative effectiveness of mechanical prophylaxis such as mobile Compression Devices

Pulmonary Embolism (PE) is a condition where a blockage is formed in the pulmonary artery or one
of its branches by a blood clot or foreign material. Some of the causes of such a condition can
include smoking, predisposition, polycythemia, cancer, pregnancy, surgery and immobilisation for
prolonged periods of time. Symptoms indicating the condition appear as varying degrees of chest
pain, shortness of breath and coughing up blood. In the US alone, the death count is about 60,000 –
100,000 people every year from this disease. 10 – 30% of these people were expected to die in their
first month of diagnosis (Blood Clot Forming in a Vein, 2015). So it is extremely important to
diagnose the condition as early as possible. Throughout history, one of the most prevalent ways of
diagnosing this condition has been through the methods of electrocardiography and plain chest
radiography (Riedel, n.d.). These tests are considered to be the most basic of tests in diagnosing the
condition and ... Show more content on Helpwriting.net ...
The simplest type of separation is known as the imaging slice. Protons only exchange energy
efficiently if the frequency of the energy matches frequency of precession. So, the 90 and 180
degree pulses must be sent at the Larmor frequency of the proton. Hence, by combining this with
gradients, a selected slice of the body can then be imaged. By altering the frequency of the 90 and
180 degree pulses, different protons will then experience excitation. Certain slices to be imaged can
be selected by turning on the gradient fields and altering the excitation pulses (0°, 180°) frequency
to match the frequency of the slice in the desired position. Protons that are not within the slice will
not experience excitation by the gradient fields as their Larmor frequency will not be the same as the
frequency of the pulse, thus the energy of the pulse will not be

The Treatment Of A Nurse
As a nurse we are trained to take all the necessary steps to save lives. However, there are situations
that the people we are caring for tends to refuse treatment, and we have to respect their decision.
According to the HDC (Health and Disability Commissioner) Code of Health and Disability
Services Consumers' Rights Regulation 2004, every citizen has the right to make an informed choice
and give informed consent. Services like medication can only be provided if the consumer gives an
informed consent. In regards to the situation I have experienced in the facility, the patient has the
right to refuse to take the Warfarin. Even if this poses a risk to his health the members of the health
care team has to respect his decision. I truly respect the decision of the patient. I empathize with his
decision not to take the Warfarin because it needed for the INR to be monitored which causes
discomfort in him since it was difficult to extract blood from him. However, the Warfarin is a very
important medicine needed because of his medical condition.
Warfarin is used to prevent blood clots from forming or growing larger in your blood and blood
vessels. It is prescribed for people with certain types of irregular heartbeat, people with prosthetic
(replacement or mechanical) heart valves, and people who have suffered a heart attack. Warfarin is
also used to treat or prevent venous thrombosis and pulmonary embolism. Warfarin is in a class of
medications called anticoagulants. It works

Superficial Thrombophlebothrombois
As it was defined in Oxford Concise Medical Dictionary, phlebothrombosis is "an obstruction of a
vein by a blood clot, without preceding inflammation of its wall. It is most common within the deep
veins of the calf of the leg – deep vein thrombosis (DVT) – in contrast to thrombophlebitis, which
affects superficial leg veins. Prolonged immobility, heart failure, pregnancy, injury, and surgery
predispose to thrombosis by encouraging sluggish blood flow. Many of these conditions are
associated with changes in the clotting factors in the blood that increase the tendency to thrombosis;
these changes also occur in some women taking oral contraceptives. The affected leg may become
swollen and tender. The main danger is that the clot may become detached and give rise to
pulmonary ... Show more content on Helpwriting.net ...
It is used also in follow–up to determine wether it has grown or to ensure that there's no other new
ones.
Blood tests: which will show increased blood level of D dimer (a clot dissolving substance).
Venography: a procedure that involves injection of a dye into the vein in the lower limb and taking
an X–ray image to visualize clots. It is a painful invasive procedure that may cause contract reaction
and procedure–induced DVT
CT or MRI
Management: (3,9)
Anticoagulant drugs are used to reduce and block the process of blood clotting. They differ from
anti–platelet medications such as low–dose aspirin and clopidogrel.
Aspirin: It is an anti–platelet medicine which reduces the risk of clots formation and thus reducing
the risk of heart attacks and strokes. It can be used in several conditions such as unstable angina,
AMI, strokes, asthma, gastric ulceration and in ineffective post–angioplast
Surgical management: (10)
Catheter–directed thrombolysis
Replacement of venous

Pulmonary Embolism Of Lipids
Lipids are a vital component to sustaining human life. While important, an excess or insufficient
amount of lipids can cause detrimental health effects, such as skin problems, heart disease, and other
illnesses. An illness affected by lipids is pulmonary embolism. Pulmonary relates to the lungs, while
embolism is the obstruction of the arteries. Due to excess lipids, it will have a negative effect on
pulmonary embolism. Lipids are a diverse group of molecules that is hydrophobic, encompassing all
fatty acids and their derivatives. They are essential in human life, functioning as a long term energy
source, a heat insulator, and a membrane structure for cells and organelles. Fatty acids are a
component of lipids, with a basic structure of a

Deep Vein Thrombosis Case Study
Deep Vein Thrombosis (DVT) is a serious medical condition that affects certain hospitalized
patients. The healthcare team, especially the registered nurse, must understand what this condition
entails, who it affects, and how to prevent and treat this condition. The proper knowledge and
training will allow the registered nurse to be able to keep the patients safe and help prevent
complication from deep vein thrombosis.
A DVT is a blood clot that can occur anywhere in the body, but these blood clots tend to occur in the
deep veins of the legs and thighs. It is critical that these clots are diagnosed and treated promptly to
prevent further complications such as a pulmonary embolism, which occurs when a blood clot
travels from the lower extremities ... Show more content on Helpwriting.net ...
The registered nurse must be observant of any clinical signs that require further assessment such as
the signs and symptoms stated earlier in this paper. Previously, nurses were taught to use the
Homan's sign to assess for a DVT. After extensive research, it has been found that the Homan's sign
is not as effective as previously documented. Therefore, after additional research, the registered
nurse can use the Wells model when assessing a patient for a DVT. The Wells model is a numerical
scale similar to other scales used within the nursing practice and consists of a scoring system that
predicts the likelihood of a DVT. The Wells model assesses for the following criteria: if a patient has
active cancer, any paralysis, if the patient has been bedridden for more than 3 days or had a major
surgery within the last 4 weeks, Is the patient experiencing any local tenderness, any swelling or
pitting edema in the leg or calf, or is there an alternative diagnosis that is more likely than a DVT.
These areas are scored with a number 1 if positive and a 0 if negative. A score of 3 or more would
indicate a high probability for a DVT. A score of 1 or 2 would indicate a moderate probability, and a
score of 0 would indicate a low probability of a DVT. When doing an assessment, the registered
nurse can quickly use the Wells model to determine if further assessment is

Embolism Case Studies
This first clinical of med–surg at 3 North, was a little nerve–racking. I wasn't sure how I was going
readapt myself to this, on the floor clinical experience. I wasn't sure what to expect for this clinical,
all I was sure about was to go with the flow and learn. The patient I had chosen to care for during
pre–assessment, was a 93–year–old lady that had chest pain and CAD. I looked forward caring for
the patient but I had a bad feeling about the patient before I got to clinical. Unfortunately, the patient
was taken to ICU and I had to choose a new patient. My new patient that I had was a 52–year–old
male, who was admitted for acute respiratory failure with hypoxia and with pulmonary embolism.
The patient was on 2L of oxygen with a nasal cannula and had an IV infusion of Heparin. He was
very alert of his situation and communicated well with the nurses and I during clinical. Before
meeting my new patient, I was anxious as I didn't know what to expect from him. As I met him and
saw that he was comfortable having a student nurse caring for him, it ... Show more content on
Helpwriting.net ...
By knowing this information, I had a better understanding of his treatments of Heparin and O2.
During my assessment, I understood that my patient would have diminished breath sounds as it's in
result of his respiratory insufficiency. As I got to review more of my patient's chart, I was able to
further understand that his respiratory insufficiency is the result of pulmonary embolism (PE). With
PE, "large emboli obstruct pulmonary blood flow, leading to reduced gas exchange, reduced
oxygenation, pulmonary tissue hypoxia, decreased perfusion, and potential death" (Ignatavicius &
Workman, 2016); that's to name some factors that are affecting my patient. As the emboli disrupts
oxygenation and causes hypoxia, seeing how the treatment of O2 and Heparin were significant to
my patient was

PCA Embolism
Embolism from a cardiac source is the number one etiology of a PCA stroke, as embolism from a
significant proximal vertebrobasilar disease is less common. PCA resulting from the stenosis is
uncommon.
The posterior cerebral artery can be very difficult to diagnose because the etiology of PCA infraction
can't be determined in a quarter of the patients.
There are two main territories for the vascular supply of the PCA. The proximal
PCA territory involves the paramedian midbrain, the medial thalamus, and the posterolateral
thalamus. The distal territory of the PCA stroke is composed of the cerebral hemisphere, occipital
lobe, parietal, and posterior temporal lobes. Proximal atherosclerotic stenosis of the vertebral or
basilar artery is a course

Thrombolytic Therapy Research Paper
Thrombolytic therapy
Definitions: Thrombolytic therapy is a treatment to dissolve dangerous clots in the blood vessels, to
improve blood flow and prevent damage to tissue and organs.
Thrombolytic therapy can also be said as, Thrombolysis. Thrombolysis may involve the injection of
clot–busting drugs through an intravenous (IV) line or through a long catheter that delivers drugs
directly to the site of the blockage. It also may involve the use of a long catheter with a mechanical
device attached to the tip that either removes the clot or physically breaks it up.
Thrombolysis is often used as an emergency treatment to dissolve blood clots that form in arteries
feeding the heart and brain –– the main cause of heart attacks and ischemic strokes

Pulmonary embolism (PE) accounts for up to 30,000 deaths each year. (Beckman, 2014). It has been
estimated that nearly one–third of deaths stemming from pulmonary embolism occur within the first
hour. (Muckart, 2010). It can prove to be extremely difficult to diagnose pulmonary embolism due
to the wide range of symptoms and presentations, or lack there of. (Muckart, 2010; Tarbox &
Swaroop, 2013). Some patients with acute pulmonary embolism, possibly as many as 50%, are
completely asymptomatic. (Muckart, 2010). Although the clinical presentation can vary
dramatically, some of the main symptoms include tachycardia, sub–sternal chest pain, dyspnea,
hypoxemia, hypotension and even possibly shock. (Tarbox & Swaroop, 2013). There are several risk
factors attributed to PE, including but not limited to, recent immobilization, previous myocardial
infarction or cerebral vascular accident, prior surgery or recent trauma. (Tarbox & Swaroop, 2013).
Initial symptoms primarily present with severe respiratory distress, but the main adverse effects of
PE effect the cardiovascular system due to the fact that the embolus causes an occlusion in the
pulmonary vasculature. (Muckart, 2010). The obstruction within the pulmonary artery vastly
increases vascular resistance, which results in right ventricular failure; therefore the left ventricular
preload is minimized and cardiac output collapses. (Muckart, 2010). ... Show more content on
Helpwriting.net ...
(2010). Acute pulmonary embolism. The New England Journal of Medicine, 363(3), 266–74.
Beckman, J. (2014). Thrombolytic therapy for pulmonary embolism. JAMA, 311(23), 2385–6.
Konstantinides, S., & Goldhaber, S. (2012). Pulmonary embolism: Risk assessment and
management. European Heart Journal, 33(24), 3014–3022.
Muckart, David. (2010). Pulmonary embolism. CME: Your SA Journal of CPD, 28(6), 293.
Tarbox, A., & Swaroop, M. (2013). Pulmonary embolism. International Journal of Critical Illness
and Injury Science, 3(1),

Pulmonary Embolism: A Case Study
Pulmonary embolism arises as a thrombus formation or blood–borne substance from vascular wall
damage, venous stasis, or blood hypercoagulability and obstruct blood flow. Due to trauma, clot
dissociation, sudden muscle spasm, intravascular pressure changes, or peripheral blood flow
changes can cause the thrombus to loosen and relocate throughout the body (Porth 2004). The
thrombus breaks off and travels through the blood stream, this is now called an embolus. Pulmonary
embolism is when the the embolus drifts into the right side of the heart and enters the lung through
the pulmonary artery (Wolters Kluwer, 2017). A blood–borne substance could mean a few different
things. This could mean a thrombus (clot), an air bubble that was accidentally injected during an
intravenous infusion, fat that has been mobilized from the bone marrow after ... Show more content
on Helpwriting.net ...
This can also result in the area of the lungs deprived of blood and oxygen to become necrotic.
Numerous diseases and treatments lead to a higher risk of pulmonary embolism. Especially, surgical
patients. The anesthetics used in surgeries can affect the lungs by injuring the lung vessels. Also
prolonged bed rest can promote venous stasis (Wolters Kluwer, 2017).
Patients who experience prolonged bed rest, older than 40, and are obese are even more likely to
develop pulmonary embolism as a secondary diagnosis. Predisposing disorders that can increase the
risk of pulmonary embolism are cardiac arrhythmia, lung disorders, cardiac disorders, diabetes
mellitus, and more (Wolters Kluwer, 2017).
There are various ways to prevent pulmonary embolism from occurring which includes, various leg
exercises to minimize the chance for DVT to develop, the cessation of cigarette smoking in females
who use oral contraceptives, and reporting any signs and symptoms to your primary health care
physician to reduce the amplitude of the effects (Porth

Gas Embolism
As the practice of medicine advances, patients and the society in general demand medical services
(especially surgery and minor invasive procedures) that are devoid of side effects and complications.
Common among the advance medical services are laparoscopic surgery and laparoscopic diagnosis.
These procedures do not only provide accurate diagnosis and relieves to patients but also reduces
tissue trauma, pain, bleeding and above all preserves the integrity of patient's body as surgical
incision are quite smaller compared to conventional or open surgical methods.
Gas embolism is largely iatrogenic medical complication (2) that is manifested following entry of
gas / atmospheric air into the systemic venous network. (3) Previously, gas embolism was thought to
be sorely related to patients who had ... Show more content on Helpwriting.net ...
(3) In many circumstance of venous gas embolism patients has remained asymptomatic without
catastrophic consequences and hence go without reporting to hospital. Several gases have been used
in various medical procedures to improve treatment outcome. These include CO2, nitrous oxide
(NO2) and several other gases. Among the gases, CO2 has been the most widely used for
insufflation in diagnostic procedures and laparoscopic surgeries due to it high solubility in blood
chemical inertness, cost effectiveness, availability and its ability to be easily absorbed. However, in
spite of the advantages of CO2, its use in clinical practice also come with fatal complications such
as venous gas embolism, even though rare. Carbon dioxide (CO2) embolism (type of gas
embolism), is a phenomenon which can lead to serious sequelae and mortality. CO2 embolism is a
rare complication which ensues due to CO2 entrainment in the venous system. This type of
embolism occurs mostly in laparoscopic investigative procedures and laparoscopic surgeries as CO2
remain the most ideal gas for induction of pneumoperitoneum, especially in abdominal and
gynecological surgical procedures. .....Many

Social Development And Journey Towards Autonomy
In 2009, I decided I wanted to be on birth control, even though I did not fully know my body or
complete family history. Soon after, I suffered from a Pulmonary Embolism, a blood clot in my
lung. The shortness of breath and severe agonizing chest pains were almost too horrible to bare. My
life almost came to a screeching halt. It was then I found out my family suffered from a genetic
disorder and my mother realized we needed more open communication. Having open
communication with in the family positively influenced our family structure, in ways I could never
have imagined. Now I felt safe and secure in asking my mother everything; sex, love, school,
whatever it be. Parent and child relationships are a key factor in an adolescences' social development
and journey towards autonomy. Our textbook, Exploring Lifespan development (Berk, 2010), states
that "teenagers still need guidance and protection from dangerous situations. In diverse ethnic
groups and cultures, warm, supportive parenting that grants young people freedom to explore while
making appropriate demands for maturity fosters autonomy, [...] favorable self–esteem, and ease of
separation in the transition to college" (p. 329). Open discussion with the family and adequate
education are necessary to helping adolescents achieve a high standard of sexual education and
autonomy. It is at this point in my life that I met my, now husband, Joseph. Before writing my paper,
I put together my video photo collage and after

Embolism In Hospital Setting
It is not uncommon for death to occur in an unusual way in a hospital setting. One such occurrence
is frequently identified as a pulmonary embolism. The patient comes in with an initial diagnosis of
lung cancer with metastasis to the liver. She is expected to live for a few more days. To show
compassion, the nurse decides to give her a bath, change her linens, and help her become more
comfortable. After providing her with care, the patient has one more request, to get a leg massage.
Oblivious to any complications, the nurse proceeds to give the patient a good leg rub. Minutes later,
the patient is found unresponsive on the floor. The patient suffers from a venous thromboembolism
in one of her legs, that when massaged, travels all the way up ... Show more content on
Helpwriting.net ...
Anti–embolic stockings work by exerting graded circumferential pressure from distal to proximal
regions of the leg conforming to a Sigel pressure profile. These increase blood velocity, promote
venous return, and have shown to be effective (Barker, 2011). Intermittent pneumatic compression
periodically compresses the calf and thigh muscles, mimicking the muscle pump created by
walking, promoting fibrinolysis, and have shown to also be effective (Barker, 2011). Foot impulse
devices increase venous outflow and reduce stasis in immobilized patients. They also mimic
walking by compressing the plantar venous plexus, and they are effective after orthopedic surgery in
reducing asymptomatic DVT (Baker, 2011). Mechanical methods will most likely be used in
patients at high risk for bleeding. Physiotherapy and nursing has also been a method used by staff in
increasing the prevention of VTE. Risks can potentially be mediated by mechanical calf and foot
venous compression, bed exercise, active or passive, and early mobilization, and by hydration
(Barker,

Pulmonary Embolism Research Paper
A pulmonary embolism (PE) is an obstruction of a blood vessel in the lungs, usually due to a blood
clot. A saddle pulmonary embolism means that the obstruction or clot is blocking both sides of an
arterial branch of the lungs. We are all subject to developing a pulmonary embolism, but conditions
such as immobility, cancer, heart disease, and surgery can increase our risk. Some common signs
and symptoms include shortness of breath, chest pain and cough. A pulmonary embolism can
threaten your life, but immediate treatment can greatly reduce the risk of death. In addition to
prompt treatment, we can all take measures to prevent blood clots by knowing our family history,
remaining mobile, and staying hydrated. PE's can be treated surgically, ... Show more content on
Helpwriting.net ...
A V/Q scan uses radioactive material to see how well air and blood are flowing to all areas of the
lung. A pulmonary angiography is an accurate, invasive test that is used to diagnose pulmonary
embolism. A trained specialist threads a catheter through the groin or arm to the blood vessels in the
lung. A dye is then injected so that a picture can be taken of the blood flow through the blood
vessels in the lungs. Not available at all hospitals, this test is administered by a trained specialist. A
spiral CT scan is a special type of x–ray that takes pictures of structures inside the body. A doctor
will inject a dye into a vein, which will allow the blood vessels in the lungs to be seen. This is a very
quick test and results are available shortly after the scan is completed. A MRI is a test utilizing radio
waves that shows pictures of organs and structures inside the body that may not show up on an x–
ray. To check for blood clots inside the heart and to view heart function, an echocardiogram may be
ordered. This test uses sound waves. It can also determine other possible causes for the symptoms
that are being experienced. A D–dimer is a blood test that measures a substance in the blood that is
released when a clot breaks up. High levels may indicate a clot. A

Air Entering The Vascular System
Purpose:
Air embolism is a rare but potentially fatal consequence of air entering the vascular system. It can
result from a wide range of procedures, including those related to vascular access in interventional
radiology, in addition to open surgical procedures. We set out to review all cases of air embolism at
our institution over a 25–year period, including analysis of cause, clinical signs and symptoms,
treatment and prognosis.
Materials and Methods:
Institutional board review for this retrospective study was obtained. A centralized clinical data
registry was searched for all cases of air embolism over a 25–year period using the ICD–9–CM code
for air embolism, 958.0. Additionally, a separate database of radiology reports was searched for the
terms "air embolism", "air embolus" and other related terms over the same time period. The data
were combined and the relevant medical records were reviewed. Patients with imaging evidence or
high clinical suspicion of air embolism were identified. Inclusion criteria included the presence of
sudden desaturation, reduced end–tidal CO2, acute cardiopulmonary compromise as defined by the
need for cardiopulmonary resuscitation or vasopressors, acute neurological change including motor
or sensory changes or the presence of seizures. Additionally, all patients needed to have a clearly
defined antecedent event, including open, laparoscopic or endovascular procedures, central or
peripheral line placement or removal (Figure 1) or an

Fat Embolism Case Study
1. Define Disease process: blockage of an artery usually by a blood clot however can be a fat, or air
embolism in the lungs. In this paragraph I will be discussing each type. However, for this SIM our
patient will have a blood clot (DVT– deep vein thrombosis) that breaks off and travels to the lungs
where it is lodged causes a rapid onset of problems. First I will talk about a fat embolism Fat
embolism is a process that fat tissue passes into the bloodstream that travels through the
bloodstream and lodges and blocks a blood vessel. This typically occurs between 12 to 36 hours
after an injury. A fat embolism almost always occurs with major trauma or an elective surgery that
requires intramedullary nailing of long bones. Although a fat embolism is rare it leads to occlusion
... Show more content on Helpwriting.net ...
It is usually presented by a classic triad of symptoms: 1.) respiratory changes; 2.) neurological
abnormalities; 3.) petechial rash. The client will normally present first with respiratory changes such
as dyspnoea, tachypnoea, and hypoxemia and can progress to respiratory failure. One half of the
clients with a fat embolism caused by a long bone fracture will develop severe hypoxaemia and
respiratory insufficiency and will require mechanical ventilation. Neurological changes resulting
from cerebral embolism produces signs in 86% of cases and often occur after respiratory distress.
The changes vary from mild confusion to severe seizures. The most common being confusion with
focal neurological signs such as hemiplegia, aphasia, apraxia, and anisocoria. The third in the triad
the petechial rash will be the last to develop and it occurs in 60% of the cases. The rash is due to
embolization of small dermal capillaries leading to extravasation of erythrocytes. The rash is in the
conjunctiva, oral mucous membranes, and skin folds of the upper body. The rash appears within the
first 36 hours and disappears completely within 7

PQRST Pain Assessment

Recommended

Recommended

More Related Content

More from Dana Boo

More from Dana Boo (20)

Recently uploaded

Recently uploaded (20)

PQRST Pain Assessment