NURSING MANAGEMENT OF PATIENT WITH PULMONARY EMBOLISM

1. THARA NOEL
I year MSc Nursing
Lourdes college of
nursing

2. Pulmonary embolism is the
blockage of the main artery
of the lung or one of its
branches by a substance that
has travelled from elsewhere
in the body throgh the blood
stream.

8. NON
MASSIVE
MASSIVE
SUB
MASSIVE

10. ALTERATION IN BLOOD
FLOW
FACTORS IN THE
VESSEL WALL
PROCOAGULANT STATE

11. THROMBOSIS
FAT
AIR
AMNIOTIC
FLUID
TUMOUR
TISSUE
DIALYSIS

12. SURGERY
LONG TRAVELL
PREGNANCY
OBESITY
FRACTURE
BURNS
OLD AGE

13. THROMBOPHILIA
HORMONES
CANCER,AIDS,SLE
HEART DISEASE
POLYCYTHEMIA
SMOCKING

15. PULMONARY ARTERY
OBSTRUCTION
RELEASE OF HUMORAL
SUBSTANCES
DECREASRED ALVEOLAR
PERFUSION
LOSS OF SURFACTANT

17. PHYSICAL EXAMINATION
WELLS SCORE
BLOOD INVESTIGATIONS
IMAGING
ECG&ECHOCARDIOGRAM

18. CLINICALLY SUSPECTED DVT 3.0
PE IS ≠1 DIAGNOSIS 3.0
TACHYCARDIA 1.5
IMMOBILISATION 1.5
HISTORY OF DVT OR PEORE 1.5
HEMOPTYSIS 1.0
MALIGNANCY 1.0

19. ≥ 7.0 HIGH PROBABILITY
2.0-6.0 INTERMEDIATE
PROBABILITY
0.2-0 LOW PROBABILITY

20.  PULMONARY ANGIOGRAPHY
 LUNG SCINTIGRAPHY
 CXR
 CT LUNG
 LEG DOPPLER
 MRI

21.  D-DIMER
 CBC
 COAGULATION STUDY
 ESR
 RFT
 LFT
 ELECTROLYTES

22. EMERGENCY CARE
DRUGS
IVC FILTER
SURGERY

23. O2 100%
OBTAIN IV ACCESS
SUPPORT CIRCULATION
SMALL DOSE OF MORPHINE
 INTENSIVE MONITORING
BASE LINE INVESTIGATIONS

25. UNFRACTIONATED
HEPARIN
LMWH
WARFARIN

32. CORE
PULMONALE
RESPIRATORY
ACIDOSIS
SHOCK AND
DEATH

33. SEPTIC-
EMIA
CARDIAC
TAMPON-
ADE
AORTIC
DISSECTI
-ON
PNEUM-
ONIA
PNEUMO
THORAX
ACS

34. . •ANTI COAGULATION
. •STOCKINGS
. •EXCERCISE
. •ADEQUATE HYDRATION
•WEIGHT REDUCTION
•STOP SMOCKING

38.  INEFFECTIVE BREATHING
PATTERN
 INEFFECTIVE TISSUE
PERFUSION
 ACUTE CHEST PAIN
 RISK FOR INJURY
 ANXIETY
 KNOWLEDGE DEFICIT

41.  ASSESS FOR SIGNS OF PAIN
 AUSCULTATE FOR FRICTION RUB
 ADMINISTER MORPHINE
 PROVIDE SEMIFOWLER’S POSITION
 SPLINT CHEST WHILE COUGHING
 EVALUATE SIGNS OF HYPOXIA

45.  VERBALISES LESS SOB
 STABLE VITAL SIGNS
 ADEQUATE URINE OUT PUT
 VERBALISES RELIEF FROM PAIN
 PROGRESS WITH OUT
COMPLICATION
 VERBALISES RELIEF FROM ANXIETY
 UNDERSTANDING OF DISEASE
PROCESS

46.  REGULAR FOLLOW UP
 USE SOFT TOOTH BRUSH
 USE ELECTRIC SHAVER
 AVOID CONTACT SPORT
 OBSERVE FOR SIGNS OF BLEEDING
 ADOPT BIRTH CONTROL MEASURES
 STOP SMOCKING AND ALCOHOLISM
 REGULAR EXERCISE AND REST .

47.  WIKIPEDIA,THE FREE
ENCYCLOPEDIA
 eMEDICINE EMERGENCY MEDICINE
 MEDLINE PLUS
 MAYOCLINIC.COM
 eMEDICINE PULMONOLOGY
 THE MERCK MANUALS -ON LINE
MEDICAL LIBRARY