Please help me with this question

Question

Mr. Jim had R total hip replacement 1 day ago. He's having trouble coughing up secretions after her surgery, complaining of SOB & a sensation of "tightness" in his chest, pale & sweating. His apical rate is 127 bpm, laboured resp. rate of 26, and BP of 140/90.

-Why is he having difficulty coughing secretions? Explain.

-Why is he experiencing SOB? Explain.

-Why is he pale & sweating? Explain.

-Explain his VS.

-What assessments should you do?

-What's his Nursing Diagnosis?

-Identify Interventions (treatment/preventions)

Answer 1

Hi Nanno,

Whenever we have a patient who is postoperative we have certain complications we are always being mindful of. I hate to answer all of these questions directly because I can see this is an assignment from school, I want to guide you in the right direction without doing your homework for you.

Complications we look for: bleeding, pulmonary embolism (PE), pain, infection, DVT, stroke, circulation issues, etc.

In this situation, the SOB could be related to a PE. The PE could cause all of the symptoms listed above and in fact could affect his ability to cough, do to lack of oxygenation. The types of assessments we want to do are related directly to his signs and symptoms. We would definitely want to get a pulse ox on this patient, as well as obtaining vitals. Checking perfusion peripherally would also help us identify if indeed this patient is having a perfusion issue. If the patient is declining quickly we need to call a rapid response, the doctor, and throw some oxygen on this patient, as well as placing cardiac leads. Follow our orders. As far as nursing diagnosis': risk of poor perfusion, risk of cardiac arrest, risk of deoxygenation, etc.

I hope this helps point you in the right direction!

Deserae

Answer 2

First it is normal to have coughing after surgery

Chest pain is also not so serious every time but you need to monitor it