1. Gorski, Lisa A. MS, APRN, BC, CRNI, FAAN


Mrs. Jones, 75 years old, is a long-term home care patient with multiple medical diagnoses, including chronic obstructive pulmonary disease, asthma, heart failure, and diabetes. She was recently hospitalized for a severe exacerbation of her respiratory disease. Mrs. Jones has chronic leg and back pain due to arthritis, usually managed to her satisfaction with acetaminophen. About 5 days after returning home, she complained of increasing pain in her leg that she attributed to her arthritis. There were no additional signs of circulatory problems or inflammation such as edema or redness. Two days later, Mrs. Jones suffered a syncopal episode at home and went to the emergency department. She was hospitalized and 3 days later, after ruling out other causes, the physician tested for and found evidence of pulmonary embolism (PE). She returned home with the newly added medication of warfarin.