A 70 y/o female who had undergone right total hip replacement presents on the 5t

Question

A 70 y/o female who had undergone right total hip replacement presents on the 5th postoperative day with central chest pain and acute-onset dypsnea. HPI. She has been immobile since the surgery PE. VS: low-grade fever; tachycardia; hypotension. central cyanosis; elevated Jugular venous pressure (JVP); right ventricullar gallop rythm with widely split S2 Labs. Arterial Blood Gas (ABGs); hypoxia and hypercapnia (type 2 respiratory failure). patient had sinus tachycardia on ECG Imaging. Doppler Ultrasound shot clot in the right common femoral vein. CXR, showed right lower lobe atelectasis. V/Q scan demonstrated three areas of ventilation-perfusion mismatch in right lung. Angio-pulmonary: confirmatory; (not rrequired if V/Q scan is high probability). Gross pathology. Large thrombus seen in pulmonary artery Micro pathology. Large occlusive thrombus seen in pulmonary artery with variable degree of recanalization. 1) Please provide two nursing differential diagnoses for this presentation

Explanation / Answer

Acute coronary syndrome as the patient age is of 70 years and have central chest pain and acute dysnea.

Pneumothorax as patient have sudden onset of dyspnea.

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