Clinical Assessment and Interventions

Answer the following questions based on Mr. Smith’s presentation and history.

Discuss the conditions that could be causing Mr. Smith’s shortness of breath given his clear chest x-ray. Your response should be a minimum of 150 words. Mr. Smith’s shortness of breath is due to deep venous thrombosis. Deep venous thrombosis is a common complication associated with fractures, prolonged immobilization, and lower limb surgery. Mr. Smith has the three risk factors for deep venous thrombosis. His decline in mobility, lower limb surgery after the accident, and fractured limb predisposed him to deep venous thrombosis. Patients with deep venous thrombosis experience symptoms, including leg swelling, pain, tenderness, increased warmth, unexplained shortness of breath, and skin discoloration in the affected limb (Zhao et al., 2021). A clear chest radiograph rules out causes such as pulmonary embolism in Smith’s case. Similarly, the absence of fever rules out fat embolism. Radiological findings in fat embolism would include the presence of diffuse interstitial infiltrates in a chest x-ray and diffuse vascular congestion and pulmonary edema when a chest CT scan is ordered (Lempert et al., 2021). The absence of these findings implies that Mr. Smith most likely has deep venous thrombosis, a complication of lower limb surgery, fracture, and prolonged immobility. Identify possible interventions that would be needed to address Mr. Smith’s shortness of breath. Include the timeframe for each intervention in your discussion. Your response should be a minimum of 150 words. One of the possible interventions that would be implemented to address Mr. Smith’s shortness of breath is supplemental oxygenation. Supplemental oxygen will be administered to Mr. Smith via a nasal cannula or face mask to assist in body tissue perfusion. The oxygen will be administered until the oxygen saturation levels are maintained above 90% when Mr. Smith is off oxygen and has no signs of respiratory distress. The second intervention is the administration of anticoagulants and blood thinners. Blood thinners such as warfarin will be administered to dissolve the blood clot. Oral anticoagulants such as heparin might also be administered to dissolve the blood clots. Anticoagulants and blood thinners will help ease the respiratory symptoms by eliminating blood occlusion by the clots. Warfarin can be taken for a long period because of its reduced risk of bleeding. Mr. Smith can be prescribed warfarin for 3-6 months (Frank et al., 2023). However, heparin is associated with an increased risk of bleeding. Therefore, he should be prescribed 5-7 days. Prioritize three to five additional interventions that would be needed to address Mr. Smith’s immediate health needs. Your response should be a minimum of 200 words. One of the prioritized interventions that should be implemented for Mr. Smith is ensuring that he is kept in an appropriate position. Mr. Smith is experiencing shortness of breath. The nurse should place him in a semi-fowlers position to ease the respiratory effort. Close respiratory monitoring should also be performed to detect changes in respiratory status and any signs of pulmonary embolism. The second intervention that should be implemented for Mr. Smith is the administration of antibiotics. Mr. Smith has a lower limb wound. He is at risk of infection, hence, the need for administering the prescribed antibiotics and analgesics. The third intervention that would be needed to address Mr. Smith’s immediate health needs is wound cleaning and dressing. The nurse should clean and dress the wound in the left lower limb to prevent septicemia. Mr. Smith’s cognitive function has declined. The decline places him at risk of harm from falls (Sabbagh et al., 2020). The nurse should ensure environmental safety and keep re-orienting Mr. Smith to prevent aggression and risk for injury. ">
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Answer for NRS 460 Benchmark – Case Study: Timothy Smith – Hospice/Palliative Care  PART II: Critical Thinking Activity

 

Use the findings from your evaluation to complete the following:

Clinical Assessment and Interventions

Answer the following questions based on Mr. Smith’s presentation and history.
Discuss the conditions that could be causing Mr. Smith’s shortness of breath given his clear chest x-ray. Your response should be a minimum of 150 words. Mr. Smith’s shortness of breath is due to deep venous thrombosis. Deep venous thrombosis is a common complication associated with fractures, prolonged immobilization, and lower limb surgery. Mr. Smith has the three risk factors for deep venous thrombosis. His decline in mobility, lower limb surgery after the accident, and fractured limb predisposed him to deep venous thrombosis. Patients with deep venous thrombosis experience symptoms, including leg swelling, pain, tenderness, increased warmth, unexplained shortness of breath, and skin discoloration in the affected limb (Zhao et al., 2021). A clear chest radiograph rules out causes such as pulmonary embolism in Smith’s case. Similarly, the absence of fever rules out fat embolism. Radiological findings in fat embolism would include the presence of diffuse interstitial infiltrates in a chest x-ray and diffuse vascular congestion and pulmonary edema when a chest CT scan is ordered (Lempert et al., 2021). The absence of these findings implies that Mr. Smith most likely has deep venous thrombosis, a complication of lower limb surgery, fracture, and prolonged immobility.
Identify possible interventions that would be needed to address Mr. Smith’s shortness of breath. Include the timeframe for each intervention in your discussion. Your response should be a minimum of 150 words. One of the possible interventions that would be implemented to address Mr. Smith’s shortness of breath is supplemental oxygenation. Supplemental oxygen will be administered to Mr. Smith via a nasal cannula or face mask to assist in body tissue perfusion. The oxygen will be administered until the oxygen saturation levels are maintained above 90% when Mr. Smith is off oxygen and has no signs of respiratory distress. The second intervention is the administration of anticoagulants and blood thinners. Blood thinners such as warfarin will be administered to dissolve the blood clot. Oral anticoagulants such as heparin might also be administered to dissolve the blood clots. Anticoagulants and blood thinners will help ease the respiratory symptoms by eliminating blood occlusion by the clots. Warfarin can be taken for a long period because of its reduced risk of bleeding. Mr. Smith can be prescribed warfarin for 3-6 months (Frank et al., 2023). However, heparin is associated with an increased risk of bleeding. Therefore, he should be prescribed 5-7 days.
Prioritize three to five additional interventions that would be needed to address Mr. Smith’s immediate health needs. Your response should be a minimum of 200 words. One of the prioritized interventions that should be implemented for Mr. Smith is ensuring that he is kept in an appropriate position. Mr. Smith is experiencing shortness of breath. The nurse should place him in a semi-fowlers position to ease the respiratory effort. Close respiratory monitoring should also be performed to detect changes in respiratory status and any signs of pulmonary embolism. The second intervention that should be implemented for Mr. Smith is the administration of antibiotics. Mr. Smith has a lower limb wound. He is at risk of infection, hence, the need for administering the prescribed antibiotics and analgesics. The third intervention that would be needed to address Mr. Smith’s immediate health needs is wound cleaning and dressing. The nurse should clean and dress the wound in the left lower limb to prevent septicemia. Mr. Smith’s cognitive function has declined. The decline places him at risk of harm from falls (Sabbagh et al., 2020). The nurse should ensure environmental safety and keep re-orienting Mr. Smith to prevent aggression and risk for injury.

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