Question 1: The nurse knows that Vernon Watkins is most at risk for developing which of the following
complications following a pulmonary embolism?
Cardiogenic shock: the nurse must be alert for the potential complication of cardiogenic shock or right
ventricular failure subsequent to the effect of pulmonary embolism (PE) on the cardiovascular system
Question 2: what initial objective and subjective data in Mr. Watkin’s case should lead the nurse to
suspect a pulmonary embolism?
Pain in the leg, resistance to ambulate – Vernon Watkin’s stated that he had a painful leg and he was
refusing to ambulate this morning (immobility) increases the risk for stasis of blood, which may lead to a
deep vein thrombosis in the calf with potential sequelae of pulmonary embolism (PE) should the clot be
released and travel to the lungs
Question 3: Vernon Watkins arterial blood gas results were reported as: pH 7.47, PaCO2 32 mmHg
HCO3 mEq/L, PaO2 74 mmHg. How would the nurse best interpret these results?
Respiratory alkalosis with mild hypoxemia – occurs when pH is greater than 7.45 and PaCO2 is less than
35 mmHg. Normal PaO2 is 80 to 100 mmHg, so a PaO2 reading below 80 mmHg indicates hypoxemia
Question 4: A D-dimer assay was ordered. The nurse understands that which of the following is the
purpose of this test?
To detect evidence of clotting – D-dimer is a blood test used to screen thrombus formation
Question 5: In patient who has had a hemicolectomy, the nurse would expect to find which type of
bowel sounds four hours Post-op?
Absent – patients undergoing bowel surgery will not have bowel sounds present in the immediate post
op period. Decreased peristalsis occurs due to the effects of the anesthetic and analgesia and due to
manipulation of the abdominal organs during surgery
Question 6: Vernon was originally admitted through emergency with a diagnosis of bowel perforation.
Complications can include peritonitis. Which is a hallmark sign of peritonitis that the nurse should
assess?
Diffuse pain with rebound tenderness – symptoms depends on the location and extent of inflammation.
Over time the affected area of the abdomen becomes extremely tender and distended. Rebound
tenderness will also develop
Question 7: if Vernon developed oliguria, the nurse should assess which of the following lab values?
Creatinine – an elevated creatinine level would indicate renal dysfunction. Hypoglycemia or
hyperglycemia conditions would be assessed by a glucose level. Bicarbonate levels assess the state of
acidosis or alkalosis. Creatine kinase is used in the diagnosis of MI’s, neuro disease or skeletal muscle
disease
Question 8: Vernon is receiving morphine for his pain. In addition to resp. depression, the nurse would
monitor for what other adverse effect of this medication?
This study source was downloaded by 100000839380065 from CourseHero.com on 06-28-2022 00:10:14 GMT -05:00
https://www.coursehero.com/file/64182974/Vernon-watkins-vsim-100docx/
complications following a pulmonary embolism?
Cardiogenic shock: the nurse must be alert for the potential complication of cardiogenic shock or right
ventricular failure subsequent to the effect of pulmonary embolism (PE) on the cardiovascular system
Question 2: what initial objective and subjective data in Mr. Watkin’s case should lead the nurse to
suspect a pulmonary embolism?
Pain in the leg, resistance to ambulate – Vernon Watkin’s stated that he had a painful leg and he was
refusing to ambulate this morning (immobility) increases the risk for stasis of blood, which may lead to a
deep vein thrombosis in the calf with potential sequelae of pulmonary embolism (PE) should the clot be
released and travel to the lungs
Question 3: Vernon Watkins arterial blood gas results were reported as: pH 7.47, PaCO2 32 mmHg
HCO3 mEq/L, PaO2 74 mmHg. How would the nurse best interpret these results?
Respiratory alkalosis with mild hypoxemia – occurs when pH is greater than 7.45 and PaCO2 is less than
35 mmHg. Normal PaO2 is 80 to 100 mmHg, so a PaO2 reading below 80 mmHg indicates hypoxemia
Question 4: A D-dimer assay was ordered. The nurse understands that which of the following is the
purpose of this test?
To detect evidence of clotting – D-dimer is a blood test used to screen thrombus formation
Question 5: In patient who has had a hemicolectomy, the nurse would expect to find which type of
bowel sounds four hours Post-op?
Absent – patients undergoing bowel surgery will not have bowel sounds present in the immediate post
op period. Decreased peristalsis occurs due to the effects of the anesthetic and analgesia and due to
manipulation of the abdominal organs during surgery
Question 6: Vernon was originally admitted through emergency with a diagnosis of bowel perforation.
Complications can include peritonitis. Which is a hallmark sign of peritonitis that the nurse should
assess?
Diffuse pain with rebound tenderness – symptoms depends on the location and extent of inflammation.
Over time the affected area of the abdomen becomes extremely tender and distended. Rebound
tenderness will also develop
Question 7: if Vernon developed oliguria, the nurse should assess which of the following lab values?
Creatinine – an elevated creatinine level would indicate renal dysfunction. Hypoglycemia or
hyperglycemia conditions would be assessed by a glucose level. Bicarbonate levels assess the state of
acidosis or alkalosis. Creatine kinase is used in the diagnosis of MI’s, neuro disease or skeletal muscle
disease
Question 8: Vernon is receiving morphine for his pain. In addition to resp. depression, the nurse would
monitor for what other adverse effect of this medication?
This study source was downloaded by 100000839380065 from CourseHero.com on 06-28-2022 00:10:14 GMT -05:00
https://www.coursehero.com/file/64182974/Vernon-watkins-vsim-100docx/
