A patient is 2 days postoperative for a hip replacement, and her mobility is limited. The patient complains of pleuritic chest pain, shortness of breath, and hemoptysis, and her oxygen saturation level is 82% to 84%
The nurse should anticipate administration of ___________, for the signs and symptoms of ____________.
a. heparin; pulmonary embolus
b. furosemide (Lasix); right-sided heart failure
c. hydrochlorothiazide (HydroDIURIL); pulmonary edema
d. tissue plasminogen activator (tPA); myocardial infarction
ANS: A
The scenario describes the signs and symptoms of pulmonary emboli, as well as the patient's risk factors for pulmonary embolism. Heparin is the preferred anticoagulant because of its rapid onset of action.
Furosemide would not be indicated in this situation, because the patient is not experiencing signs or symptoms of right-sided heart failure.
Hydrochlorothiazide would not be indicated in this situation. Although shortness of breath and decreased oxygen saturations are consistent with pulmonary edema, the patient typically produces excessive amounts of frothy sputum.
Although the patient is experiencing chest pain, the presentation of the pain is inconsistent with that of myocardial infarction, therefore tPA is not indicated. Although tPA can also be administered in pulmonary embolism, the patient's recent surgery prevents this.
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