clarence care plan - Julissa Valtierra Clarence Hughes...

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Julissa Valtierra 03/21/2016 Clarence Hughes Criterion #1 Nursing diagnosis Impaired gas exchange R/T pulmonary embolism AEB ventilation perfusion scan showing pulmonary embolus in right lung. Criterion #2 Explanation of Nursing Diagnosis Pulmonary embolisms typically come from a thrombi in a deep vein of the thighs or lower legs. These type of clots could dislodge and make its way to the lungs causing a blockage which is called a pulmonary embolism. Once the clot is lodged in the lung it can cut off blood supply to a portion of the lung causing lung damage. Signs and symptoms of this disease would be shortness of breath and sharp pain coming from embolism site and shortness of breath. (“Exploring Pulmonary Embolism,” n.d) Criterion #3 Information R/T Nursing Diagnosis Subjective: states “I suddenly feel like I can’t breathe”, reports “I have an intense sharp pain on the right side of my chest”. Pt. reported pain level of a 9 on a scale of 0 to 10 in right side of chest and describes it as a sharp intense pain.

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