Arthur Rosen is a 78-year-old widower who lives alone. He has a historyof atrial fibrillation and ha
Arthur Rosen is a 78-year-old widower who lives alone. He has a historyof atrial fibrillation and has a prescription for warfarin 5 mg once a day. Arthur finished his Coumadin prescription 3 weeks ago and did not have an opportunity to obtain the refill. He was admitted to the hospital for treatment of an ischemic stroke attributable to cerebral emboli. His manifestations were paralysis and anesthesia of the left leg. During the morning assessment the nurse notices Arthur’s left thigh is red and edematous. Arthur tells the nurse his left upper leg feels achy. The circumference of the right leg is 51 cm, whereas the circumference of the left leg is 53 cm. Arthur has no feeling in his left leg. His vital signs reveal temperature 98° F, blood pressure 140/72 mm Hg, heart rate 86 beats/min and irregularly irregular, respiratory rate 18 breaths/min. Based on these recent changes, the nurse suspects a deep vein thrombosis (DVT) and notifies the physician of these changes. An ultrasound of the extremity is performed and confirms a DVT. Arthur is prescribed immediate full bed rest and a new order for intravenous heparin is started until his INR is ?2.0 for 24 hours. Also the nurse notifies the physical therapist of the suspected DVT so that therapy can be rescheduled. The nurse elevates Arthur’s left leg on two pillows and does not perform the passive range-of-motion exercises of the lower extremities she had earlier planned. The case study states, “Whereas the circumference of the right leg is 51 cm, the circumference of the left leg is 53 cm.” What meaning does this information have?If you were caring for Arthur and you saw him massaging his left upper leg, what would you do?When Arthur’s INR reaches his therapeutic level, the physician will prescribe him coumadin PO. As the nurse do you turn off Arthur’s Heparin gtt when he swallows the coumadin? What is your rationale?If Arthur had a 7th grade reading level tell me exactly how you would teach Arthur about his homegoing instructions for his new coumadin prescription? Remember, he doesn’t understand medical terminology. Arthur begins to have a nose bleed. What will you do for him immediately? Health Science Science Nursing NMNC 4410 Share QuestionEmailCopy link Comments (0)
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