An adult female client develops a pulmonary embolism and is admitted to the intensive care unit (ICU). While completing the client's health history interview, which statement made by the client is consistent with the diagnosis? Select all that apply.
A. "I had an open appendectomy 4 days ago." A 4 cm incision noted to RLQ, staples intact and edges well-approximated.
B. "I have taken oral contraceptives for the last 7 years."
C. "I am not a smoker."
D. "The nurse on the surgical unit really wanted me to sit on the side of the bed after surgery and to start walking with them later that evening, but I was so nauseated and in so much pain that I couldn't."
E. "I had some muscle cramping and tenderness in my left leg before they moved me to Intensive Care."
A,B,D,E
Rationale:
Ambulating after surgery is important to help prevent blood clots from forming. Major surgeries can increase the client's risk for developing a blood clot. Oral contraceptive use can increase the client's risk for clotting. The client most likely had a deep vein thrombosis before the pulmonary embolism developed. Smoking cigarettes can increase the client's risk for developing a deep vein thrombosis that can turn into a pulmonary embolism.
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