Pulmonary embolism (PE) is a sudden blockage of the pulmonary artery caused by a thrombus, fat, air, or tumor tissue. Key clinical features include shortness of breath, chest pain, and irregular heartbeat, with diagnostic measures like CT scans and D-dimer tests used for confirmation. Management involves initial treatment with oxygen, medications including anticoagulants and thrombolytics, and nursing care focused on monitoring and preventing complications.

1. LIST OF CONTENTS-
 Definition
 Causes
 Pathophysiology
 Clinical features
 Diagnostic measures
 Management- initial, drug, filter, surgery
 Nursing care
 Complication
 Prevention
 Pulmonary embolism

3. PULMONARY EMBOLISM
Sudden blockage of the pulmonary artery by a
thrombus,fat,air embolus or tumor tissue.

4. ETIOLOGY
- DVT
- Injury or damage
- Inactivity
- Medical conditions- surgery or chemotherapy for
cancer
- Cigarette smoking

6. PATHOPHYSIOLOGY
Clot /embolus
Travel in blood stream through veins in abdomen /leg
Reaches Rt side of heart through SVC
Rt atrium
Rt ventricle
Lodges in pulmonary artery
Obstruction of blood flow
PE

8. CLINICAL FEATURES
 Shortness of breath
 Anxiety, diaphoresis
 clammy or bluish skin
 chest pain (worsened
by breathing)
 fainting
 irregular heartbeat
 Dyspnea, tachypnea
 Tachycardia
 Hemoptysis
 Weak pulse
 Cough
 Cardiac arrest
 Sudden death, Collapse,
Apnea

9. D/M
 History & PE
 Ventilation–perfusion scan
 Pulmonary angiography
 CXR, CT, MRI
 ECG
 Peripheral vascular studies
 ABG
 Doppler ultrasonography
o D-dimmer test - Normal :less than1.37 nmol/L

10. TREATMENT
Initial
Drugs
Filter
Surgery

11. INITIAL MANAGEMENT
 O2 100 %
 IV access
 Morphine small dose
 Intensive monitoring
 Baseline investigations

12. DRUGS
Narcotics
Eg: Morphine
Vasopressor
Eg:
Noradrenaline
Ionotropes
Eg: Dopamine
Thrombolytics
Eg: STK,
Reteplase
Anticoagulants
Eg: Heparin,
Warfarin, LMWH

13. IVC FILTER

15. NURSING DIAGNOSIS
 Acute chest pain related to poor cardiac tissue perfusion
 Ineffective breathing pattern related to poor lung perfusion
 Impaired gas exchange related to ventilation perfusion
mismatch
 Ineffective tissue perfusion related to poor cardiac output
 Risk for complications related to poor organ perfusion
 Anxiety related to sudden and progressive dyspnoea and fear
of death
 Knowledge deficit related to timely management of embolism

16. INEFFECTIVE TISSUE PERFUSION
 Signs of hypoperfusion
 O2
 Bed rest
 Monitor urine output
 Passive ROM

17. RISK FOR COMPLICATION
 Vital signs- hypotension
 Check bleeding
 GCS
 Lab values- ABG- acidosis
 Urine output

18. ANXIETY
 Monitor symptoms
 Listen to patient
 Explain
 Speak calmly and slowly
 Correct misconception

19. COMPLICATIONS
Corpulmonale
Respiratory acidosis
Shock and death

20. PREVENTION
Anticoagulation
Stockings
Pneumatic compression stockings
Hydration
Weight reduction
Stop smoking

21. QUESTIONS…
1. Parameters in Virchow’s triad?
2. Eg. for anticoagulant used in pulmonary
embolism?