Acute pulmonary embolism.

Over the next 5 days, Mr. R continues to respond well to treatment. He’ll continue on the prescribed warfarin regimen, with scheduled follow-up to evaluate his condition and adjust the dosage if necessary. He’s instructed to continue wearing his GCS as an outpatient. Mr. R and his wife are given individualized instructions to prepare Mr. R for discharge. Mr. and Mrs. R participate in a thorough review of safe anticoagulation management, including the importance of taking warfarin exactly as prescribed. They’re taught strategies to avoid missing a dose, and Mr. R is instructed not to take more than the prescribed dose. They’re taught to recognize signs and symptoms of lower extremity DVT such as pain, redness, swelling, and warmth. Signs and symptoms of PE are also reviewed, including sudden onset of difficulty breathing, rapid respiratory rate, and pleuritic chest pain. If any of these symptoms occur, Mr. and Mrs. R are instructed to call emergency medical services immediately. The importance of postdischarge follow-up appointments with Mr. R’s PCP is emphasized. Mr. R is advised to avoid eating foods or using supplements high in vitamin K. Mr. R is also encouraged to stay active, but to use caution to prevent injuries and avoid falls by engaging in activities such as walking and, when approved, swimming.