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