Reference no: EM133281190
A 68-year-old female presented at the hospital complaining of severe pain in her left leg, shortness of breath, and pleuritic type chest pain following a long drive from Maine to Florida with minimal stopping. The patient had a history of pulmonary embolism, degenerative joint disease, and previously was a chronic smoker. Her vital signs were: temperature 38.4 °C, pulse 98 bpm, respiratory rate 20 breaths per minute, and blood pressure 138/89 mm Hg. Her weight is 155 pounds. Basic metabolic panel and complete blood count values were within the normal range. She had been taking hydrocodone/acetaminophen 5/325 mg one tablet orally every 6 hours as needed for pain, tiotropium inhaler 18 mcg one inhalation daily, and albuterol two inhalations as needed for chronic obstructive pulmonary disease (COPD).
The chest 2 views on radiography confirmed COPD and computed tomography (CT) scanning showed bilateral pulmonary emboli. Venous Doppler ultrasound of the lower extremities also revealed extensive deep venous thrombosis in his left lower leg.
In this case, the 68-year-old patient had additive risk factors for VTE: age, history of pulmonary embolism and venous stasis after a long drive from Maine to Florida. She didn't receive active thromboprophylaxis and developed a second VTE episode which may have been preventable. As a result, treatment of acute DVT and PE was initiated in this patient.
Heparin is order what is the bolus amount of heparin that you would give this patient.