vsim Vernon Watkins.

DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS) PATIENT INFORMATION ANTICIPATED PHYSICAL FINDINGS + ANTICIPATED NURSING INTERVENTIONS Pulmonary Embolism (PE) is the blockage of one or more pulmonary arteries by a thrombus, fat or air embolus, or tumor tissue. These clots do not stop moving until they lodge at a narrowed part of the circulatory system. A pulmonary embolus consists of material that gain access to the venous system and then to the pulmonary circulation. The embolus travels with blood flow through smaller blood vessels until it lodges and obstructs perfusion of the alveoli. The lower lobes of the lungs are most commonly affected and approximately ten percent of patients die from a massive PE within the first hour. Anticoagulants significantly reduces mortality. Lewis, S. M., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2017). Medical-surgical nursing: Assessment and management of clinical problems. St. Louis, MO: Elsevier.  12-lead electrocardiogram (ECG) such as T-wave inversion, ST-segment elevation, or the development of an abnormal Q wave (may show changes indicative of ischemia)  Chest X-ray-may show infiltrates, atelectasis, elevation of the diaphragm on the affected side, or a pleural effusion  Spiral CT-Scan with contrast  Arterial blood gas analysis-it may show hypoxemia and hypocapnia (from tachypnea).  D-dimmer test  Prothrombin time  International normalized ratio Vernon Watkins is a 69- year-old male who presented to the Emergency Department 4 days ago with complaints of nausea, vomiting, and severe abdominal pain and was admitted for emergent surgery for bowel perforation and underwent a hemicolectomy.  Shortness of breath  Chest pain  Nausea  Vomiting  Abdominal pain  Anxiety  Fever  Tachycardia  Apprehension  Diaphoresis  Hemoptysis  Syncope  Maintain oxygen saturation greater than 92%  If SpO2 less than 92% administer oxygen therapy to relieve hypoxemia and dyspnea and position client in highFowler’s 90 degrees  Initiate and maintain IV access.  Administer prescribed medications  Withhold medications that may cause respiratory depression  Place 12 lead ECG to monitor cardiac status (dysrhythmias)  Vital signs every 4 hours  Monitor for signs of bleeding. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Aurora Vera primary nurse at the medical surgical unit Your name, position (RN), unit you are working on SITUATION Vernon Watkins is a 69-year-old male who presented to the Emergency Department 4 days ago with complaints of nausea, vomiting, and severe abdominal pain and was admitted for emergent surgery for bowel perforation and underwent a hemicolectomy. Patient’s name, age, specific reason for visit BACKGROUND Admitted on 07/22/2020 with a primary diagnosis of postoperative hemicolectomy. He is also getting treated for a pulmonary embolism. Current orders: -IV normal saline at 25 mL/hour -Oxygen to maintain SpO2 over 92% -Continuous ECG and SpO2 monitoring -Chest X-ray -Spiral CT-scan -12 Lead ECG - Cardiac monitoring -D-dimer -Check PTT Q6hrs and