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Pulmonary embolism

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Pulmonary embolism

  1. 1. Pulmonary Embolism Krizza Anne C. Bucok, RN
  2. 2. CLINICAL PICTURE
  3. 3. The patient may have:• Dyspnea, pleuritic chest pain, tachycardia• Anxiety, diaphoresis• Syncope, hypotension• Wheezing• Lower extremity edema• Signs and symptoms of thrombophlebitis
  4. 4. IMMEDIATE INTERVENTIONS
  5. 5. • Administer supplemental O2• Assess VS• Assess respiratory rate and work of breathing• Notify physician or NP• Place on pulse oximetry and cardiac monitor if available
  6. 6. • Document patient’s status, phone call to physician or NP, physician or NP response
  7. 7. FOCUSED ASSESSMENT
  8. 8. • Auscultate lung fields for adventitious sounds and quality of air movement• Assess O2 saturation, cardiac rhythm, VS• Assess for chest pain, leg vein tenderness• Assess for history of recent surgery, immobilization, recent DVT, malignancy
  9. 9. STABILIZING AND MONITORING
  10. 10. • Continue to assess VS, LOC, respiratory status• Initiate anticoagulant therapy (heparin) as ordered• Have second practicioner independently calculate dilutions and infusion pump programming• Chart patient status and convey to physician or NP
  11. 11. BE PREPARED TO
  12. 12. • Obtain IV access• Change or set up an O2 delivery system• Administer medications or fluids to maintain BP• Assist with obtaining diagnostic studies  CXR, V/Q scan, spiral CT scan, pulmonary angiogram
  13. 13. • Obtain ABGs• Obtain serial PPTs and titrate heparin infusion• Transfer to ICU for high acuity care or thrombolytic therapy
  14. 14. POSSIBLE ETIOLOGIES
  15. 15. • Embolization of thrombi from deep veins of the femur, pelvis, and lower extremities from multiple causes:  Venous stasis  Hypercoagulable states  Surgery and trauma  Oral contraceptive and ERT  Pregnancy

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  • lindahandley73

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    Jul. 5, 2018
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    Oct. 15, 2020

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