Case Study 3
T.V. is hospitalized with deep vein thrombosis (DVT) in her left leg as a complication of abdominal surgery. She is being treated with bed rest and anticoagulant therapy. On the third postoperative day, she suddenly experiences severe dyspnea and is placed on supplemental oxygen. A blood gas is drawn, which demonstrates hypoxemia and mild respiratory alkalosis.
Discussion Questions
1. Considering T.V.’s history, what is the most likely cause of her respiratory distress? Why?
a. The primary cause of the patient’s respiratory distress comes from hypoxemia. The hypoxemia is caused by heart failure possibly from emboli and obstructions in the circulatory system, which is causing the patient to breathe harder and faster to compensate. The mild respiratory alkalosis/hypoventilation is from the hypoxemia. The emboli is causing VA/Q mismatch.
2. What diagnostic findings would help confirm this diagnosis?
a. Diagnostic tests for blood gas, chest radiography and testing of electrolyte imbalances will give a better understanding of the patient’s respiratory condition. Knowing the PaO2 and/or PaCO2 readings will help.
3. What is the pathogenesis of the hypoxemia in this disorder?
a. The DVT in her left leg is obstructing the flow of blood/oxygen transport through the circulatory system or embolus passed through the system and is causing flow obstruction. This obstruction is disrupting the blood-oxygen exchange and causing VA/Q mismatch as the lungs are deprived of the proper blood-oxygen. This is causing the patient to compensate by breathing faster and harder which will lead to hypoventilation.
4. How will T.V.’s respiratory disorder likely be treated?
a. Some form of oxygen supplementation or mechanical ventilation will most likely treat the patient’s respiratory disorder. For more self-care forms of treatment, the patient should be informed and proficient in the breathing techniques to aid in proper ventilation. Lastly, anticoagulant therapy should proceed to
Discussion Questions
1. Considering T.V.’s history, what is the most likely cause of her respiratory distress? Why?
a. The primary cause of the patient’s respiratory distress comes from hypoxemia. The hypoxemia is caused by heart failure possibly from emboli and obstructions in the circulatory system, which is causing the patient to breathe harder and faster to compensate. The mild respiratory alkalosis/hypoventilation is from the hypoxemia. The emboli is causing VA/Q mismatch.
2. What diagnostic findings would help confirm this diagnosis?
a. Diagnostic tests for blood gas, chest radiography and testing of electrolyte imbalances will give a better understanding of the patient’s respiratory condition. Knowing the PaO2 and/or PaCO2 readings will help.
3. What is the pathogenesis of the hypoxemia in this disorder?
a. The DVT in her left leg is obstructing the flow of blood/oxygen transport through the circulatory system or embolus passed through the system and is causing flow obstruction. This obstruction is disrupting the blood-oxygen exchange and causing VA/Q mismatch as the lungs are deprived of the proper blood-oxygen. This is causing the patient to compensate by breathing faster and harder which will lead to hypoventilation.
4. How will T.V.’s respiratory disorder likely be treated?
a. Some form of oxygen supplementation or mechanical ventilation will most likely treat the patient’s respiratory disorder. For more self-care forms of treatment, the patient should be informed and proficient in the breathing techniques to aid in proper ventilation. Lastly, anticoagulant therapy should proceed to