The patient, a 28-year-old female with a history of placental abruption, anemia, and one cesarean section, was admitted to the hospital for the removal of her inferior vena cava (IVC) filter

QUESTION

Reason for admission: IV filter removal

Medical History: Placental abruption, anemia, C/S x 1

28-year-old female who develop a pulmonary embolism with a pulmonary infraction and free-floating clots in the right iliac vein. Patient underwent IVC filter placement as well as an EKOS placement. The patient use alcohol and wine very occasional; the patient is a former smoker ten years ago.

1. narrate  two-page narrative note about the patient’s removal of the IV filter, pre-procedure, and post-procedure

2.

Priority 1

Nursing Diagnosis: 

nursing intervention 1

nursing intervention 2

nursing intervention 3

nursing intervention 4

short term goal

long term goals 

Priority 2

Nursing Diagnosis: 

nursing intervention 1

nursing intervention 2

nursing intervention 3

nursing intervention 4

short term goal

long term goals 

Priority 3

Nursing Diagnosis: 

nursing intervention 1

nursing intervention 2

nursing intervention 3

nursing intervention 4

short term goal

long term goals 

ANSWER

Narrative Note

Date: [Insert Date]

Patient Name: [Insert Patient Name]
Age: 28 years
Reason for Admission: IV Filter Removal

Pre-Procedure

The patient, a 28-year-old female with a history of placental abruption, anemia, and one cesarean section, was admitted to the hospital for the removal of her inferior vena cava (IVC) filter. The IVC filter was initially placed due to the development of a pulmonary embolism with a pulmonary infarction and free-floating clots in the right iliac vein. Before the procedure, the patient’s vital signs were stable, with blood pressure at 120/80 mmHg, heart rate at 80 beats per minute, respiratory rate at 16 breaths per minute, and oxygen saturation at 98% on room air.

The patient’s medical history included occasional alcohol and wine use, with no current smoking history (quit ten years ago). The patient’s laboratory results showed normal hemoglobin levels, no abnormalities in liver function tests, and no evidence of coagulation disorders. The patient was assessed for any allergies to contrast or iodine, which were negative.

Post-Procedure

The IV filter removal procedure was performed successfully without any complications. The patient was transferred to the recovery room for monitoring. Vital signs were stable, and the patient was alert and oriented. The patient was placed on bed rest for four hours post-procedure to minimize the risk of bleeding or hematoma formation at the site. The nursing team closely monitored the patient’s vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, during the recovery period.

The patient was encouraged to perform deep breathing exercises and ambulate as soon as possible to promote circulation and prevent post-procedure complications. The nurse provided adequate pain management and ensured that the patient remained comfortable throughout the recovery process. The patient was educated on the signs and symptoms of potential complications, such as bleeding, infection, or allergic reactions, and was advised to report any unusual symptoms immediately.

Overall, the patient tolerated the IV filter removal well, and there were no immediate post-procedure complications. The patient was discharged home with appropriate instructions for self-care and follow-up appointments.

Priority 1

Nursing Diagnosis: Risk for Bleeding related to the removal of the IV filter and anticoagulation therapy.

Nursing Interventions:
Monitor the patient’s vital signs and assess for signs of bleeding or hematoma formation at the site regularly.
Instruct the patient to avoid activities that may increase the risk of bleeding, such as heavy lifting or strenuous exercise, for 24 hours post-procedure.
Administer prescribed anticoagulant medications as ordered and monitor for signs of bleeding or adverse reactions.
Educate the patient on the importance of compliance with anticoagulation therapy and the need to report any unusual bleeding or bruising immediately.

Short-Term Goal: The patient will remain free from any signs of bleeding or hematoma formation during the immediate post-procedure period.

Long-Term Goal: The patient will maintain therapeutic anticoagulation levels and minimize the risk of bleeding throughout the recovery period.

Priority 2

Nursing Diagnosis: Risk for Infection related to the invasive procedure and the presence of the IVC filter.

Nursing Interventions:
Monitor the patient’s incision site for signs of infection, such as redness, swelling, warmth, or drainage.
Ensure that the patient receives appropriate prophylactic antibiotics as ordered to prevent infection.
Educate the patient on wound care and the importance of keeping the incision site clean and dry.
Promote hand hygiene for both the patient and healthcare providers to reduce the risk of infection transmission.

Short-Term Goal: The patient will remain free from signs of infection at the incision site during the recovery period.

Long-Term Goal: The patient will maintain good wound healing and be free from infection at the incision site throughout the recovery period.

Priority 3

Nursing Diagnosis: Anxiety related to the invasive procedure and potential complications.

Nursing Interventions:
Assess the patient’s anxiety level and provide emotional support and reassurance.
Educate the patient about the IV filter removal procedure, the expected outcomes, and potential complications to alleviate anxiety.
Encourage the patient to express any concerns or fears and address them appropriately.
Utilize relaxation techniques, such as deep breathing exercises, to help the patient cope with anxiety.

Short-Term Goal: The patient will report a reduction in anxiety levels during the immediate post-procedure period.

Long-Term Goal: The patient will demonstrate effective coping strategies to manage anxiety related to the IV filter removal and recovery process.

In conclusion, the removal of the IV filter in the 28-year-old female patient with a history of pulmonary embolism was performed successfully without any complications. Nursing interventions focused on monitoring for bleeding and infection, providing education on wound care and anticoagulation therapy, and offering emotional support to alleviate anxiety. The patient tolerated the procedure well and was discharged with appropriate instructions for self-care and follow-up appointments.