Fundamentals Question #31

Question

A client in the recovery room after surgery suddenly develops chest pain, dyspnea, and hypotension. Which complication should the nurse suspect may be occurring?

Answers

  1. Pulmonary embolism
    • Rationale:

      This answer is correct because clinical manifestations of a PE include chest pain, dyspnea, and hypotension. A pulmonary embolism is a complication of surgical procedures due to multiple risk factors such as position in surgery, prolonged bed rest, immobility, obesity, and history of cancer. Nursing interventions for prevention of deep vein thrombosis (DVT) that leads to pulmonary embolism (PE) include placement of compression socks and sequential compression devices during bed rest and surgery, passive or active range of motion exercises, early post surgical ambulation, and administration of anticoagulant (enoxaparin) therapy.

  2. Severe pain
    • Rationale:

      This answer is not correct because with severe pain the client will most likely experience hypertension and not hypotension. Clinical manifestations of a PE include chest pain, dyspnea, and hypotension.

  3. Atelectasis
    • Rationale:

      This answer is not correct because signs of atelectasis (collapse of the lung) include wheezing, coughing, difficulty breathing, or shallow respirations. Clinical manifestations of a PE include chest pain, dyspnea, and hypotension.

  4. Paralytic ileus
    • Rationale:

      This answer is not correct because a paralytic ileus is paralysis of the intestines which often happens after surgery however the manifestations are; nausea, vomiting, cramping, constipation, and absent bowel sounds. Clinical manifestations of a PE include chest pain, dyspnea, and hypotension.

Overview

A complication of surgery is a pulmonary embolism (PE). Clinical manifestations include chest pain, dyspnea, and hypotension.

Explanation

Learning Outcomes

A pulmonary embolism is a complication of surgical procedures due to multiple risk factors such as position in surgery, prolonged bed rest, immobility, obesity, and history of cancer. Nursing interventions for prevention of deep vein thrombosis (DVT) that leads to pulmonary embolism (PE) include placement of compression socks and sequential compression devices during bed rest and surgery, passive or active range of motion exercises, early post surgical ambulation, and administration of anticoagulant (enoxaparin) therapy. Clinical manifestations of a PE include chest pain, dyspnea, and hypotension.

Test Taking Tip

Understanding the pathophysiology of a pulmonary embolism (PE) is helpful to understanding the symptoms. It occurs as a clot (generally from a deep vein thrombosis in the lower extremities) that moves toward the heart and sticks in the vessels of the lungs. This causes the symptoms of chest pain and dyspnea. Hypotension occurs as a response to decreased cardiac output and decrease in arterial resistance.

Video Rationale