DY 63 yo Male Ishemia of LR and Hematoma (TX: R Femoral Thombectomy (Risk…
DY 63 yo Male Ishemia of LR and Hematoma
DY is a current smoker, 2 packs a day which plays a huge factor in his HTN and this ischemia incident. The chemicals that are in the cigarettes causes damage to the arterials and triggers inflammation. These mechanisms can cause plaque buildup which than on occlude an artery, cutting off blood flow causing an ischemia attack. His chronic HTN play a factor as it is also harms the arterials and makes them resilient, causing them to harden.
TX: R Femoral Thombectomy
Risk of DVT r/t impaired mobility
Risk of Infection r/t surgery
aseptic technique followed and maintained
Risk of Pneumonia r/t imparied mobility
Promote deep breathing
Risk of contipation r/t opioid
Administer meds as directed
Impaired Mobility r/t pain
administer meds as ordered and with patient's wants
Ice and Elevation
HCT: Low, Blood loss during surgery
HGB: Low, Blood loss during surgery
RBC: Low, Blood loss during surgery
Ca++: Low, Inadequate nutrition r/t N/V
Nutrition supplements such as Booste and Juven, Iron supplement, Monitor bleeding.
Docusate 100mg PO Qam
Ibuprohen 600mg PO Q6hrs
Aspirin 81mg PO Daily
Ferrous Gluconate 324mg PO BID with meals
Lioresal 20mg PO BID
Oxycodone 15mg PO PRN Q6hrs Pain
Clopidogrel 75mg PO Qam
Metoclopramide 10mg IVP PRN N/V Q6hrs
Ondansteron 4mg IVP PRN N/V Q4hrs
Current Smoker 14 pack a week
Past Opioid depenancy
Chronic Back Pain
Allergies: Acetameinaphen, Codeine and Morphine (rash)
Risk of DVT r/t current smoker
Legs elevated when laying or sitting
Risk of MI and Stroke r/t HTN and Current smoker
Administer meds as directed
Low sodium diet
Risk of opioid addiction r/t past dependancy
Ice and elevation for pain management
Encourage communication and self-reflection
Psych/Soc: DY lives with his wife and works in construction. He has suffered from chronic back pain and has had prior opioid dependancy and he is adamant of minimal use of opioids to address his pain d/t this. He also feels that his wife is unable to handle the stress of his pain and the management of it and told me many times "i take care of my wife, she doesn't need to deal with my pain." DY is honest, straighforward with his limitation, but is motivated to get better and is compliant with cares and PT activities. I asked if he had any other family support in the area and he said no. He is in alot of pain d/t the swelling of his scrotum and penis and started to get frustrated that the only way we could address his pain was with an opioid.
He will be going home. His wife is not comfortable with helping with his cares at this time.
DY would like to get his pain more under control and managed before he goes home as he doesn't feel his wife could help him with it.
He will have a FWW and is ambulating with PT to help with the swelling of his scrotum and penis.
DY received education on his medications and was encouraged to follow the regiment.
Broached cessation of smoking and is not intereseted at this time.