Critical Care Nursing Essay

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Special Care Unit Paper
Critical Care Nursing
Derek Phillips

10/20/2010

Special Care Unit Paper
Client Care Objectives:
1.   Introduce the patient
N.K., a 75 year-old retired, widowed African American female, originally from New York living with her son.   Came to S.C. in August for a family reunion and decided to extend her stay. She currently lives with a granddaughter in Hartsville. Social history excludes smoking, illegal drugs, or alcohol. On October 11, 2008 she was admitted to Carolinas Hospital Systems with complaints of right leg pain.   The extremity was cool to touch, swollen, discolored with a blue/green appearance and no palpable pulses.   Current Medical diagnoses were a Popliteal DVT and Cellulitis of Leg.   She has no know food or drug allergies.   Pertinent past medical history includes; morbid obesity, hypothyroidism, heart problems, asthma, right knee arthroplasty and a hysterectomy.
2.   Medical Diagnosis, Pathophysiology, and Clinical Manifestations
Deep Vein Thrombosis (DVT):   Diagnosis was obtained from results of the following:   an arteriogram/Doppler, physical assessment, and lab work.   Venous thrombi typically develop within a deep vein at a site of vascular trauma and in areas of sluggish blood flow (e.g., in the venous sinuses of the calf and within a valve cusp). An accumulation of fibrin and platelets causes rapid growth in the direction of the blood flow, potentially reducing venous return. Endogenous fibrinolysis results in a partial or complete resolution of the thrombus. Residual thrombus will organize and the vein may incompletely recanalize, which often results in narrowing of the lumen and valvular incompetency. The typical symptoms of DVT include leg pain, edema, erythema, and warmth in the affected area. Physical examination might also reveal distention of collateral veins and a palpable cord if there is an associated superficial vein thrombosis. Homans's sign (calf pain upon sudden dorsiflexion of the foot) and...

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