Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 13 Perioperative Care^485


due to a drop in blood pressure associated with position change. Deep vein throm-
bosis (DVT) is a later vascular complication associated with inflammation and
decreased mobility after surgery.


HALLMARK SIGNS AND SYMPTOMS



  • Chest pain which may radiate to back, neck, jaw, or arm due to ischemia in MI

  • Shortness of breath due to altered cardiac output and tissue perfusion

  • Dizziness or lightheadedness due to diminished cardiac output and cerebral
    tissue perfusion or cardiac arrhythmia

  • Palpitations due to cardiac arrhythmia

  • Cardiac arrhythmias due to myocardial irritability—possibly due to ischemia,
    medication side effect, or electrolyte imbalance

  • Low blood pressure due to diminished cardiac output

  • Unilateral calf pain and lower extremity swelling due to DVT


INTERPRETING TEST RESULTS



  • Elevated troponin levels in MI.

  • EKG shows ST elevation or T-wave inversion with lack of oxygen delivery
    to myocardial tissue.

  • Cardiac monitor or EKG shows arrhythmia.

  • BP below normal level.

  • Doppler ultrasound of extremity shows clot within blood vessel.


TREATMENT



  • Monitor cardiac rhythm.

  • Administer antiarrhythmic medications to stabilize cardiac rhythm.

  • Administer intravenous fluids to expand circulating blood volume to raise
    blood pressure.

  • Administer blood-thinning medications to decrease likelihood of clot enlarg-
    ing or additional clots forming:

    • heparin



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