1
Case Study Analysis
Trinda Kent
Master of Science in Nursing, Walden University
NURS 6501: Advanced Pathophysiology
Yvette Glenn
September 21, 2020
This study source was downloaded by 100000857300661 from CourseHero.com on 12-24-2022 03:52:08 GMT -06:00
https://www.coursehero.com/collection/69621164/M2AssignKentTdocx/
, 2
Case Study Analysis
A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly
complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the
emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain
pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF).
The purpose of the case study analysis is to discuss the following: the cardiovascular and
cardiopulmonary pathophysiologic processes that result in the patient presenting these
symptoms, how any racial/ethnic variables may impact physiological functioning, and how these
processes interact to affect the patient.
Cardiovascular and Cardiopulmonary Pathophysiologic Processes
This patient presented to the emergency department with symptoms of a pulmonary embolus
(PE). A pulmonary embolus is occlusion or partial of the pulmonary artery or its branches by an
embolus (McCance & Huether, 2019). Pulmonary embolisms are most likely caused by a deep
vein thrombosis that dislodges and travels from the lower leg. The pulmonary embolus traveled
from the patients’ leg and lodged in his pulmonary artery. Risks factors of DVT for this patient
include immobility, the patients age, and recent orthopedic surgery. Secondary tissue damage
from surgery or trauma may lead to the release of inflammatory cytokines, which
impair fibrinolysis and down regulate endogenous anticoagulants all of which contribute to an
increased risk for VTE (Giordano et al., 2017). Some genetic risk factors are disorders in the
clotting factor, such as factor V Leiden, prothrombin gene mutation, antithrombin deficiency,
protein C and protein S deficiency, and hyperhomocysteinemia (Giordano et al., 2017). When a
thrombus lodges in the pulmonary circulation, there is a release of neurohumoral substances,
such as serotonin, histamine, catecholamines, and angiotensin II, and of inflammatory mediators,
This study source was downloaded by 100000857300661 from CourseHero.com on 12-24-2022 03:52:08 GMT -06:00
https://www.coursehero.com/collection/69621164/M2AssignKentTdocx/
Case Study Analysis
Trinda Kent
Master of Science in Nursing, Walden University
NURS 6501: Advanced Pathophysiology
Yvette Glenn
September 21, 2020
This study source was downloaded by 100000857300661 from CourseHero.com on 12-24-2022 03:52:08 GMT -06:00
https://www.coursehero.com/collection/69621164/M2AssignKentTdocx/
, 2
Case Study Analysis
A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly
complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the
emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain
pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF).
The purpose of the case study analysis is to discuss the following: the cardiovascular and
cardiopulmonary pathophysiologic processes that result in the patient presenting these
symptoms, how any racial/ethnic variables may impact physiological functioning, and how these
processes interact to affect the patient.
Cardiovascular and Cardiopulmonary Pathophysiologic Processes
This patient presented to the emergency department with symptoms of a pulmonary embolus
(PE). A pulmonary embolus is occlusion or partial of the pulmonary artery or its branches by an
embolus (McCance & Huether, 2019). Pulmonary embolisms are most likely caused by a deep
vein thrombosis that dislodges and travels from the lower leg. The pulmonary embolus traveled
from the patients’ leg and lodged in his pulmonary artery. Risks factors of DVT for this patient
include immobility, the patients age, and recent orthopedic surgery. Secondary tissue damage
from surgery or trauma may lead to the release of inflammatory cytokines, which
impair fibrinolysis and down regulate endogenous anticoagulants all of which contribute to an
increased risk for VTE (Giordano et al., 2017). Some genetic risk factors are disorders in the
clotting factor, such as factor V Leiden, prothrombin gene mutation, antithrombin deficiency,
protein C and protein S deficiency, and hyperhomocysteinemia (Giordano et al., 2017). When a
thrombus lodges in the pulmonary circulation, there is a release of neurohumoral substances,
such as serotonin, histamine, catecholamines, and angiotensin II, and of inflammatory mediators,
This study source was downloaded by 100000857300661 from CourseHero.com on 12-24-2022 03:52:08 GMT -06:00
https://www.coursehero.com/collection/69621164/M2AssignKentTdocx/
