student needs wisdom

[frisco96]

Hi! I'm a 1st year nursing student and I'm really overwhelmed trying to process a patient I had. I'm writing nursing diagnoses and I'm wondering if someone can tell me if I'm on the right track.....a little pt hx: Over 60 yo, hx of COPD, emphysema, bronchiectasis, PE/DVT, has prothrombin gene mutation (clots easily), 2 lobectomies, obese..to name a few. Pt came in with a bleeding problem. Ended up with 5.0 hgb, low hct, rec'd FFP, later hgb up to 9.5. So here's my question.....with a tendency to clot, yet pt had a hemmorhage that was repaired, and is on heparin IV....what is my priority??? Is it risk for DVT or risk for hemorrhage? I'm so confused. Any insight would be beyond helpful. I've read previous threads, but am still struggling.

Thanks!!

PS: I posted this in the student section and didn't have any responses. Maybe I'm posting wrong?

[vashtee, RN]

I would think the risk of hemorrhage is greater than the risk of clotting, due to the heparin therapy.

[frisco96]

Thank you!

[frisco96]

I forgot to mention that pt has an inferior vena cava filter in place from previous PE's. Can I have both diagnoses...risk for hemorrhage, risk for dvt?

[shoegalRN, RN]

Most patients have multiple nursing DX, so yes, the pt could have both.