NURS 143 FUNDAMENTALS OF
NURSING VERNON WATKINS (Week
9 Worksheet) HOWARD
COMMUNITY COLLEGE
, CONCEPT MAP WORKSHEET
DESCRIBE DISEASE PROCESS AFFECTING PATIENT
(INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
The patient, Mr. Watkins is a 69-year-old male who underwent a hemicolectomy. He has a midline abdominal
incision without redness, swelling, or drainage. He has refused to ambulate because of fatigue and a sore
leg. As a postoperative patient, he is at risk for complications such as atelectasis, pneumonia, deep vein
thrombosis, pulmonary embolism, constipation, paralytic ileus, and wound infection. His pulmonary
embolism (PE) is most likely the result of deep vein thrombosis related to surgery and decreased mobility.
Pulmonary Embolism (PE) is the blockage of 1 or more pulmonary arteries by a thrombus, fat or air
embolus, or tumor tissue. A PE consists of material that gains access to the venous system and then to the
pulmonary circulation. The embolus travels with blood flow through ever-smaller blood vessels until it
lodges and obstructs perfusion of the alveoli. The lower lobes of the lung are most often affected. Most PEs
arise from deep vein thrombosis (DVT) in the deep veins of the legs.
Lewis Med-Surg pg. 532
DIAGNOSTIC TESTS PATIENT INFORMATION ANTICIPATED PHYSICAL
(REASON FOR TEST AND RESULTS) FINDINGS
-
NAME: Vernon Watkins - Dyspnea
Aterial Blood Gas: test measures DOB: 04/09/1951 - Hypoxemia
the amounts of arterial gases, such GENDER: Male - Tachypnea
as oxygen and carbon dioxide. WEIGHT: 80kg - Cough
Chest X-Ray: produces images of HEIGHT: 182cm
- Chest pain
the heart, lungs, airways, blood - Hemoptysis
ALLERGIES: Penicillin - Crackles
vessels and the bones of the spine - Wheezing
Admin DX: Postoperative
and chest. - Fever
Hemicolectomy
Spiral CT Scan: will help find - Accentuation of pulmonic
Provider: n/a heart sound
problems such as
- Tachycardia
infection, lung cancer, blocked - Syncope
blood flow in the lung (pulmonary - Sudden change in mental
embolism), and status
- Hypotension
other lung problems. - Feelings of impending doom.
Venous Blood Analysis: used to
assess acid-base status along with
ANTICIPATED NURSING INTERVENTIONS
1. Provide adequate tissue perfusion and respiratory function during shift.
2. Prevent further growth or extension of thrombi in the lower extremities during shift.
3. Prevent embolization from the upper or lower extremities to the pulmonary vascular system.
4. Prevent further recurrence of PE during shift.
5. Focused assessment of patient’s cardiopulmonary status
6. Oxygen administration by mask or cannula (when hypoxemia is present) as ordered.
7. Request ABG analysis.
8. Turn patient, encourage coughing, deep breathing, and incentive spirometry to help prevent or
treat atelectasis.
9. Administer pain medication
10. Teach patient about condition.
NURSING VERNON WATKINS (Week
9 Worksheet) HOWARD
COMMUNITY COLLEGE
, CONCEPT MAP WORKSHEET
DESCRIBE DISEASE PROCESS AFFECTING PATIENT
(INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
The patient, Mr. Watkins is a 69-year-old male who underwent a hemicolectomy. He has a midline abdominal
incision without redness, swelling, or drainage. He has refused to ambulate because of fatigue and a sore
leg. As a postoperative patient, he is at risk for complications such as atelectasis, pneumonia, deep vein
thrombosis, pulmonary embolism, constipation, paralytic ileus, and wound infection. His pulmonary
embolism (PE) is most likely the result of deep vein thrombosis related to surgery and decreased mobility.
Pulmonary Embolism (PE) is the blockage of 1 or more pulmonary arteries by a thrombus, fat or air
embolus, or tumor tissue. A PE consists of material that gains access to the venous system and then to the
pulmonary circulation. The embolus travels with blood flow through ever-smaller blood vessels until it
lodges and obstructs perfusion of the alveoli. The lower lobes of the lung are most often affected. Most PEs
arise from deep vein thrombosis (DVT) in the deep veins of the legs.
Lewis Med-Surg pg. 532
DIAGNOSTIC TESTS PATIENT INFORMATION ANTICIPATED PHYSICAL
(REASON FOR TEST AND RESULTS) FINDINGS
-
NAME: Vernon Watkins - Dyspnea
Aterial Blood Gas: test measures DOB: 04/09/1951 - Hypoxemia
the amounts of arterial gases, such GENDER: Male - Tachypnea
as oxygen and carbon dioxide. WEIGHT: 80kg - Cough
Chest X-Ray: produces images of HEIGHT: 182cm
- Chest pain
the heart, lungs, airways, blood - Hemoptysis
ALLERGIES: Penicillin - Crackles
vessels and the bones of the spine - Wheezing
Admin DX: Postoperative
and chest. - Fever
Hemicolectomy
Spiral CT Scan: will help find - Accentuation of pulmonic
Provider: n/a heart sound
problems such as
- Tachycardia
infection, lung cancer, blocked - Syncope
blood flow in the lung (pulmonary - Sudden change in mental
embolism), and status
- Hypotension
other lung problems. - Feelings of impending doom.
Venous Blood Analysis: used to
assess acid-base status along with
ANTICIPATED NURSING INTERVENTIONS
1. Provide adequate tissue perfusion and respiratory function during shift.
2. Prevent further growth or extension of thrombi in the lower extremities during shift.
3. Prevent embolization from the upper or lower extremities to the pulmonary vascular system.
4. Prevent further recurrence of PE during shift.
5. Focused assessment of patient’s cardiopulmonary status
6. Oxygen administration by mask or cannula (when hypoxemia is present) as ordered.
7. Request ABG analysis.
8. Turn patient, encourage coughing, deep breathing, and incentive spirometry to help prevent or
treat atelectasis.
9. Administer pain medication
10. Teach patient about condition.
