My 79 year old mother suffered a rt hip fracture this past Monday. She was hospitalized until yesterday when she was transferred to a skilled nursing facility for rehab. She is unable to weight bear/ambulate. She did not require surgery for her 3 fractures in her right hip. She tells me she was on Lovenox in the hospital but it was not ordered for her at the skilled nursing facility. Her current med list includes Plavix 75mg qd, Bumex 1mg po qd, Coreg 3.125mg bid, vitamin D3, CoQ10, Xalatan oph gtts qhs, synthroid, kcl 30meq po qd, probiotic, florastor, hydrocodone/apap 10/325 q4h ATC (not prn) which she has been refusing.
Her PMH includes dual valve replacement due to aortic stenosis in 2012, hypothyroidism due to thyroid removal (Graves disease), previous DVT, Celiac disease, hx of breast CA, lymphedema due to mastectomy in right arm and bilat LE, cholecystectomy, OA, HTN, obesity, multiple medication allergies and sensitivities, hysterectomy, bacterial endocarditis in 1/14.
Her current symptoms that are cause for my concern are: anxiety, altered mental status, dizziness, nausea, substernal pain, edematous upper extremities (she says she can hardly bend her fingers), sweating, agitation, shortness of breath. Last vitals taken: 98.8F, 167/78, hr 74.
I am concerned about the development of a PE since lovenox has not been given since yesterday morning at the hospital ( I presume she was on a daily prophylactic dose). What are your thoughts?