The case study discusses a patient with post operative atelectasis. Here is a mini-case study. Tell me what vital signs you'd expect to find in the list below.74 year old female s/p lung cancer has post partial lobectomy of RML (right middle lobe) performed at the hospital. She is 5'3", 265 pounds, 90 pack-year smoking history with moderate ascites. One hour after surgery in PACU, her RR increases from 18 to 32. The patient is on room air. What other signs/vital signs would you expect. Please choose all that apply. Group of answer choicesdiminished BS on right sideHR 135SpO2 of 99% on RAelevation of the hemidiaphragm on the RH sideSpO2 88% on RAdecreased vocal fremitusincreased vocal fremituselevation of the hemidiaphragm on the left hand side
Question
The case study discusses a patient with post operative atelectasis. Here is a mini-case study. Tell me what vital signs you'd expect to find in the list below.74 year old female s/p lung cancer has post partial lobectomy of RML (right middle lobe) performed at the hospital. She is 5'3", 265 pounds, 90 pack-year smoking history with moderate ascites. One hour after surgery in PACU, her RR increases from 18 to 32. The patient is on room air. What other signs/vital signs would you expect. Please choose all that apply. Group of answer choicesdiminished BS on right sideHR 135SpO2 of 99% on RAelevation of the hemidiaphragm on the RH sideSpO2 88% on RAdecreased vocal fremitusincreased vocal fremituselevation of the hemidiaphragm on the left hand side
Solution
Based on the case study, the following signs/vital signs would be expected in a patient with post-operative atelectasis:
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Diminished breath sounds (BS) on the right side: This is due to the removal of the right middle lobe of the lung. The lung tissue that remains will likely be less able to transmit sound.
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Heart rate (HR) of 135: The body may respond to decreased oxygen levels by increasing the heart rate in an attempt to deliver more oxygen to the tissues.
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Oxygen saturation (SpO2) of 88% on room air (RA): Atelectasis can cause a decrease in oxygen saturation because there is less lung tissue available for gas exchange.
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Elevation of the hemidiaphragm on the right hand (RH) side: The removal of a portion of the lung can cause the diaphragm on that side to move upwards.
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Decreased vocal fremitus: This is a vibration that can be felt on the chest wall during speech. It may be decreased due to the removal of lung tissue.
Increased vocal fremitus and elevation of the hemidiaphragm on the left hand side are not expected findings in this case.
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