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Introduction
In identifying the elements that may present significant factors for the diagnosis, it is necessary to thoroughly examine the patients symptoms, considering the type of operation the patient is recovering from and necessary ethnic variables. The patient is recovering from a knee replacement conducted about a week ago, which means that the patients mobility is currently limited to walking with the assistance of crutches. Traditionally, the total knee replacement operation was offered for individuals suffering from intolerable pain or significant activity limitation, which could signal a lack of mobility for the patient before surgery (Price et al., 2018). However, as operation becomes more popular among the younger population, focusing on reduced movement in the operated leg and the risks of blood clots development can be more helpful in this case.
Discussion
Furthermore, considering the patients age, one can suggest that there is a higher percentage of risk that the operation will cause complications in older patients due to comorbidities. However, the study conducted by Klasan et al. (2019) defined that there is no correlation between patients age and surgical complications in total knee replacement operations. Thus, in this case, considering the cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms presents the primary strategy in identifying the potential factors in the diagnosis.
The patient complained about shortness of breath, heart palpitations, and pain in the chest region. The symptoms suggest the pulmonary embolism diagnosis, which occurs when a blood vessel in the lungs is blocked by a blood clot. One of the common risks of knee replacement operation is the occurrence of venous thromboembolism, or deep vein thrombosis (DVT). DVT is a condition in which blood clots occur deep in the vein with the risk of breaking away. The condition is worsened by the fact that there can be no noticeable symptoms of DVT before it progresses to pulmonary embolism, in which the blood clot travels to the lungs. In the lungs, the blood clot prevents blood flow, reducing the oxygen level in the patients blood and causing damage to internal organs. Pulmonary embolism can cause significant T-wave inversion; therefore, the inversion of T-wave in patients can signal the pulmonary embolism. In this case, the EKG revealed T-wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF), which signals the pulmonary embolism diagnosis.
Considering the role of ethnic variables in physiological functioning, in this case, a specific population is at higher risk of developing venous thromboembolism (VTE). According to Owens et al. (2018), African American population has a higher risk of developing VTE after total knee arthroplasty surgery. The authors defined that African Americans have higher chances of complications from the surgery, including deep venous thrombosis, and pulmonary embolism, even though the overall mortality rate is similar across patients from different races (Owens et al., 2018). Thus, considering the racial variable, in this case, can provide significant information about the patients physiological functioning constructing a more comprehensive basis for the diagnosis.
Conclusion
In conclusion, this case study focused on analyzing presented symptoms and identifying which elements should be considered for the diagnosis statement. The analysis determined that patients symptoms of pleuritic chest pain, heart palpitations, and breath shortens combined with T-wave inversion signal the pulmonary embolism diagnosis. The analysis also defined that information about the patients ethnicity can be considered a diagnosis factor in this case because African Americans have a higher risk of developing pulmonary embolism after total knee replacement surgery.
References
Klasan, A., Putnis, S. E., Yeo, W. W., Fritsch, B. A., Coolican, M. R., & Parker, D. A. (2019). Advanced age is not a barrier to total knee arthroplasty: A detailed analysis of outcomes and complications in an elderly cohort compared with average age total knee arthroplasty patients. The Journal of Arthroplasty, 34(9), 1938-1945. Web.
Owens, J. M., Bedard, N. A., Dowdle, S. B., Gao, Y., & Callaghan, J. J. (2018). Venous thromboembolism following total knee arthroplasty: Does race matter? The Journal of Arthroplasty, 33(7), 239-243. Web.
Price, A. J., Alvand, A., Troelsen, A., Katz, J. N., Hooper, G., Gray, A., Carr, A., & Beard, D. (2018). Knee replacement. The Lancet, 392(10158), 16721682. Web.
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