Trombosis Prophylaxis: A Case Study

An eighty-five year old female came in with lower abdominal pain that had persisted for a few days. This patient has a history of hypertension, gastroesophageal reflux disease (GERD), dyslipidemia, glaucoma, deep venous thrombosis prophylaxis, and is a former smoker that quit 10 years ago. She has not been diagnosed with COPD or any other respiratory problems and had not had any significant surgeries. When she came into the emergency department her vitals were as follows: blood pressure 121/57, heart rate 61, respiratory rate 24, temperature 97.4, breath sounds clear, and SpO2 99% on room air. These vitals are in normal range for a patient of her age. She was admitted to the floor for further monitoring and was given a CT of the stomach. This CT was however not read until the next morning. During the night the patient was in a lot of pain. She became severely worse and developed nausea and vomiting. The patient ultimately went into atrial fibrillation. An electrocardiogram was done and resulted in atrial fibrillation with fast ventricular response and a left bundle branch block. Once this was treated and under control the patient went for an echocardiogram and the results from this were: left ventricle ejection fraction of 62%, left ventricular hypertrophy, mitral valve …show more content…
An arterial blood gas was done thirty minutes later with a pH of 7.25, CO2 of 43, O2 of 103, and a Bicarb of 18.9 on the above settings. The FiO2 was then lowered to 50%. Diverticuli will cause a blood gas to be metabolic instead of respiratory so knowing all the values of the gas are important. A chest x-ray was done and resulted in old granulomatous disease in both lungs, and plate like atelectasis in the right lower lobe, patchy infiltrates or atelectasis in the left lower lobe. The patient needed to be monitored since the atelectasis could produce a