A pulmonary embolism occurs when a blood clot forms elsewhere in the body and travels to the lungs, blocking an artery. The document discusses the definition, incidence, risk factors, pathophysiology, clinical presentation, diagnostic evaluation including imaging tests, and management of pulmonary embolism with medications, surgery, and nursing care. The goal of treatment is to dissolve clots and prevent new ones from forming to stabilize the patient's cardiopulmonary status.
Pulmonary embolism occurs when one or more arteries in the lungs become blocked by blood clots, usually originating from deep veins in the legs. It can cause sudden shortness of breath, chest pain, and coughing up blood. While potentially life-threatening, prompt treatment with anti-clotting medications can greatly reduce the risk of death if pulmonary embolism is diagnosed. A variety of tests are used to diagnose pulmonary embolism including chest x-rays, CT scans, ventilation-perfusion scans, and angiograms.
This document discusses 3 case presentations of patients with Behcet's disease seen at Assiut University hospital in Egypt. Case 1 involved a male patient with recurrent hemoptysis who was diagnosed with Behcet's disease based on oral and genital ulcerations and iritis. Case 2 was a blind male with recurrent hemoptysis and ulcerations who received a Behcet's diagnosis. Case 3 involved a patient with hydatid cysts and pulsating lesions who was also found to have Behcet's. The document then reviews Behcet's disease, including its characteristics, criteria for diagnosis, prevalence, and involvement of the lungs, which can include pulmonary artery aneurysms, thrombosis, and organizing pneumonia
This document provides an overview of pulmonary edema in children, including definitions, classifications, pathogenesis, clinical manifestations, diagnosis, management, and prognosis. Pulmonary edema can be cardiogenic, caused by elevated pressures in the heart, or non-cardiogenic (ARDS). Common causes in children include pneumonia, sepsis, and congestive heart failure. Symptoms include fast breathing and cough. Chest x-rays and BNP levels help diagnose the type. Treatment focuses on oxygen, ventilation if needed, and addressing the underlying cause such as using diuretics, vasodilators, and inotropes for cardiogenic edema. Outcomes depend on the severity of the primary condition but ARDS mortality can be over 50% without treatment.
Acute pulmonary embolism is a form of venous thromboembolism that occurs when a blood clot breaks off and lodges in the pulmonary arteries of the lungs. The clinical presentation of PE can be variable and non-specific, making diagnosis challenging. It is important to efficiently evaluate patients suspected of having a PE to diagnose and treat it quickly in order to reduce morbidity and mortality. Treatment involves hemodynamic and respiratory support, initial anticoagulation with drugs like heparin, and potentially reperfusion therapies for more severe cases including thrombolysis or embolectomy.
Venous thromboembolism (VTE) refers to deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE results from Virchow's triad of stasis, hypercoagulability, and endothelial injury. DVT commonly occurs in the deep leg veins and can embolize to the lungs, causing PE. Diagnosis involves a clinical probability assessment, D-dimer testing, Doppler ultrasound, CT pulmonary angiography, or VQ scan. Risk factors include cancer, immobilization, older age, and genetic thrombophilias. Treatment is immediate anticoagulation with heparin or low molecular weight heparin, followed by long-term oral anticoagulation
Post-COVID Pulmonary Embolism - Symptoms, Causes and Treatment.pdfEmmily Zia
Post-COVID Pulmonary Embolism is a life-threatening condition that can be prevented with early diagnosis and swift treatment. Learn about the symptoms, causes, and treatment of this condition here.
Lung cysts can develop due to various conditions like cystic lung diseases or infections. Common types are blebs, bullae and honeycombing. Symptoms include breathing difficulties, cough and fatigue. Diagnosis involves tests like CT scans. Treatment depends on the underlying cause but may include surgery to remove cysts or medications to manage symptoms. Preventing conditions like smoking can reduce the risk of developing lung cysts.
Acute myocardial infarction critical care cardiologyGiovanna Trujillo
This document discusses the evaluation and diagnosis of acute chest pain in the intensive care unit setting. It describes that chest pain requires immediate evaluation to diagnose potentially life-threatening causes like acute myocardial infarction. While AMI is a major concern, there are many cardiac and non-cardiac causes of chest pain that require testing and diagnostic evaluation. Common causes discussed in detail include pericarditis, pulmonary embolism, musculoskeletal pain, and acute myocarditis.
Pulmonary embolism occurs when one or more arteries in the lungs become blocked by blood clots, usually originating from deep veins in the legs. It can cause sudden shortness of breath, chest pain, and coughing up blood. While potentially life-threatening, prompt treatment with anti-clotting medications can greatly reduce the risk of death if pulmonary embolism is diagnosed. A variety of tests are used to diagnose pulmonary embolism including chest x-rays, CT scans, ventilation-perfusion scans, and angiograms.
This document discusses 3 case presentations of patients with Behcet's disease seen at Assiut University hospital in Egypt. Case 1 involved a male patient with recurrent hemoptysis who was diagnosed with Behcet's disease based on oral and genital ulcerations and iritis. Case 2 was a blind male with recurrent hemoptysis and ulcerations who received a Behcet's diagnosis. Case 3 involved a patient with hydatid cysts and pulsating lesions who was also found to have Behcet's. The document then reviews Behcet's disease, including its characteristics, criteria for diagnosis, prevalence, and involvement of the lungs, which can include pulmonary artery aneurysms, thrombosis, and organizing pneumonia
This document provides an overview of pulmonary edema in children, including definitions, classifications, pathogenesis, clinical manifestations, diagnosis, management, and prognosis. Pulmonary edema can be cardiogenic, caused by elevated pressures in the heart, or non-cardiogenic (ARDS). Common causes in children include pneumonia, sepsis, and congestive heart failure. Symptoms include fast breathing and cough. Chest x-rays and BNP levels help diagnose the type. Treatment focuses on oxygen, ventilation if needed, and addressing the underlying cause such as using diuretics, vasodilators, and inotropes for cardiogenic edema. Outcomes depend on the severity of the primary condition but ARDS mortality can be over 50% without treatment.
Acute pulmonary embolism is a form of venous thromboembolism that occurs when a blood clot breaks off and lodges in the pulmonary arteries of the lungs. The clinical presentation of PE can be variable and non-specific, making diagnosis challenging. It is important to efficiently evaluate patients suspected of having a PE to diagnose and treat it quickly in order to reduce morbidity and mortality. Treatment involves hemodynamic and respiratory support, initial anticoagulation with drugs like heparin, and potentially reperfusion therapies for more severe cases including thrombolysis or embolectomy.
Venous thromboembolism (VTE) refers to deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE results from Virchow's triad of stasis, hypercoagulability, and endothelial injury. DVT commonly occurs in the deep leg veins and can embolize to the lungs, causing PE. Diagnosis involves a clinical probability assessment, D-dimer testing, Doppler ultrasound, CT pulmonary angiography, or VQ scan. Risk factors include cancer, immobilization, older age, and genetic thrombophilias. Treatment is immediate anticoagulation with heparin or low molecular weight heparin, followed by long-term oral anticoagulation
Post-COVID Pulmonary Embolism - Symptoms, Causes and Treatment.pdfEmmily Zia
Post-COVID Pulmonary Embolism is a life-threatening condition that can be prevented with early diagnosis and swift treatment. Learn about the symptoms, causes, and treatment of this condition here.
Lung cysts can develop due to various conditions like cystic lung diseases or infections. Common types are blebs, bullae and honeycombing. Symptoms include breathing difficulties, cough and fatigue. Diagnosis involves tests like CT scans. Treatment depends on the underlying cause but may include surgery to remove cysts or medications to manage symptoms. Preventing conditions like smoking can reduce the risk of developing lung cysts.
Acute myocardial infarction critical care cardiologyGiovanna Trujillo
This document discusses the evaluation and diagnosis of acute chest pain in the intensive care unit setting. It describes that chest pain requires immediate evaluation to diagnose potentially life-threatening causes like acute myocardial infarction. While AMI is a major concern, there are many cardiac and non-cardiac causes of chest pain that require testing and diagnostic evaluation. Common causes discussed in detail include pericarditis, pulmonary embolism, musculoskeletal pain, and acute myocarditis.
This document discusses cell counts on cerebrospinal fluid (CSF) and other body fluids. It defines CSF and other serous fluids like pleural, pericardial, and synovial fluid. The analysis and clinical significance of CSF is explained, including how to perform cell counts, quality control measures, and sources of error. A normal CSF analysis includes a gross examination, cell count and differential count, and measurements of glucose and protein. An increased number of neutrophils in the CSF differential count indicates bacterial infection or meningitis.
This document discusses analysis of cerebrospinal fluid (CSF) and other body fluids. It defines CSF as the fluid found in the subarachnoid space of the brain, and explains that CSF is analyzed to diagnose conditions like meningitis. The document outlines the procedure for CSF analysis, including collecting CSF via lumbar puncture, examining its appearance, and performing cell counts and differentials. It also discusses the clinical significance of CSF analysis and quality control measures for body fluid examinations.
Cardiac catheterization involves inserting thin plastic tubes called catheters into arteries and veins in the heart to take X-ray images and measure pressures. It can be used for diagnostic or therapeutic purposes to evaluate conditions like coronary artery disease. The history of the procedure began in the 1920s and it has evolved with developments like balloon angioplasty. It involves accessing the arteries or veins to pass catheters into the heart chambers and coronary arteries to visualize structures and take measurements. Potential complications include infection, bleeding, reaction to contrast dye, and damage to blood vessels or heart. The procedure ends with removing the catheters and closing the arterial access point.
Pulmonary embolism (PE) is a common and potentially deadly condition where blood clots block the pulmonary arteries in the lungs. The document discusses the pathophysiology, risk factors, clinical presentation and diagnostic workup of PE. Treatment involves anticoagulation with heparin or warfarin to prevent further clotting. A simplified diagnostic algorithm is proposed utilizing pre-test probability, D-dimer testing and CT angiography to efficiently evaluate for PE.
This document discusses various pleural diseases and how to evaluate pleural effusions. It describes common causes of pleural effusions including congestive heart failure, liver cirrhosis, parapneumonic effusions, malignant effusions, and tuberculous effusions. Evaluation of pleural effusions involves thoracentesis and analysis of pleural fluid characteristics to determine if the effusion is a transudate or exudate. Further tests such as pH, cytology, cultures and biopsies may be needed to identify the underlying cause.
This document discusses endocarditis, including its clinical manifestations and diagnosis. It notes that fever occurs in 80% of patients, while nonspecific symptoms like weakness and weight loss are also common. Diagnosis involves meeting criteria outlined by the modified Duke criteria, which consider major and minor clinical factors as well as positive blood cultures and echocardiogram results. Common causative organisms include streptococci, enterococci, staphylococci and HACEK bacteria in 5-10% of community-acquired cases.
This document discusses endocarditis, including its clinical manifestations, causative organisms, diagnosis, and management. Some key points include:
- Fever, nonspecific symptoms, heart murmurs, and embolic phenomena are common clinical manifestations.
- Common causative organisms include streptococci, enterococci, staphylococci, and HACEK bacteria.
- Echocardiography plays an important role in diagnosis, with TEE being more sensitive than TTE.
- The modified Duke criteria are used to diagnose definite or possible endocarditis based on clinical and echocardiographic findings.
- Complications like perivalvular abscesses may require surgical intervention.
Sarcoidosis from head to toe: What the radiologist needs to knowAbhineet Dey
Sarcoidosis is a multisystem granulomatous disorder characterized by development of noncaseating granulomas in various organs.
Clinical features are often nonspecific, and imaging is essential to diagnosis.
Abnormalities may be seen on chest radiographs in more than 90% of patients with thoracic sarcoidosis. Symmetric hilar and mediastinal adenopathy and pulmonary micronodules in a perilymphatic distribution are characteristic features of sarcoidosis. Irreversible pulmonary fibrosis may be seen in 25% of patients with the disease.
Although sarcoidosis commonly involves the lungs, it can affect virtually any organ in the body.
Computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography/CT (PET/CT) are useful in the diagnosis of extrapulmonary sarcoidosis, but imaging features may overlap with those of other conditions.
Familiarity with the spectrum of multimodality imaging findings of sarcoidosis can help to suggest the diagnosis and guide appropriate management.
Pharmacotherapy of ischemic heart diseasetolcha regasa
This document provides an overview of ischemic heart disease (IHD). It defines IHD and divides it into stable angina and acute coronary syndrome (ACS), with ACS further divided into non-ST-segment elevation myocardial infarction (NSTEMI)/unstable angina (UA) and ST-segment elevation myocardial infarction (STEMI). The causes of ACS are also discussed, with plaque rupture being identified as the predominant cause in over 90% of patients. Clinical features, diagnostic workup, and treatment approaches for the different classifications of IHD are described.
This document provides an overview of ischemic heart disease (IHD). It defines IHD as a syndrome arising from an imbalance between oxygen supply and demand in the myocardium. IHD is broadly divided into stable angina and acute coronary syndrome (ACS). ACS includes non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina (UA), and ST-segment elevation myocardial infarction (STEMI). The document discusses the causes, pathogenesis, clinical features, diagnosis, and treatment of these IHD conditions.
Pulmonary embolism presenation by Henok OnchoHenok Oncho
A pulmonary embolism is a blockage in the lungs caused by a blood clot that forms elsewhere in the body and travels through the bloodstream. Symptoms include shortness of breath, chest pain, and anxiety. Diagnosis involves tests like CT scans, ventilation-perfusion scans, and pulmonary angiograms. Treatment focuses on anticoagulant medications like heparin to prevent further clotting and reduce the risk of additional embolisms. Nursing care monitors the patient's oxygenation status and educates them on preventing future clots.
Cerebral Air Embolism – A Rare Complication of Computed Tomography Guided Lun...BRNSSPublicationHubI
Thoracic lesions constitute a major chunk of the conditions presenting to a pulmonologist. They comprise a panorama of assorted etiologies ranging from benign lung lesions to aggressive malignancies. A tissue biopsy and its histopathological analysis is the gold standard for diagnosis. Computed tomography (CT)-guided lung biopsy is a safe and imminent tool for obtaining a tissue biopsy of underlying thoracic pathology. However, it has its own gamut of complications. The most common complications encountered include pneumothorax, hemorrhage, hemoptysis, iatrogenic infections, and sporadically air embolism. Cerebral air embolism is a fatal complication of CT-guided lung biopsy seen in a miniscule subset of patients. It requires urgent diagnosis and prompt therapy initiation. High-flow oxygen and hyperbaric oxygen therapy are usually helpful. Due to heterogeneous presentation, it usually remains undiagnosed. A high index of suspicion and early initiation of appropriate therapy can save precious lives. We hereby report a unique case of this rarefied complication.
Pleurisy is inflammation of the pleura, the thin lining of tissue that surrounds the lungs. It causes sharp chest pain that worsens with breathing. The document discusses the types, causes, symptoms, diagnosis, and treatment of pleurisy. The main causes are infections like pneumonia, tuberculosis, and viruses. Diagnosis involves chest x-rays, fluid analysis, and other tests. Treatment focuses on the underlying cause through antibiotics, anti-inflammatories, pain medication, and procedures to drain fluid from the lungs.
Pericarditis is an inflammation of the pericardium that commonly affects men aged 20-50. It has several causes including viral or bacterial infections, certain cancers, autoimmune diseases, or physical trauma. Symptoms include chest pain that increases with deep breathing or lying flat. Diagnosis involves electrocardiograms, echocardiograms, and blood tests. Treatment focuses on reducing inflammation with medications like aspirin, ibuprofen, or colchicine. Surgery may be required in severe cases to drain fluid or remove the pericardium.
Pulmonary embolism is a potentially deadly condition caused by blood clots in the lungs. It is difficult to diagnose due to non-specific symptoms. Imaging tests like CT scans and ventilation-perfusion scans are used to identify clots in the lungs. Prompt diagnosis and treatment are important to reduce the high mortality rate associated with untreated pulmonary embolism.
Respiratory failure occurs when the respiratory system fails to oxygenate blood and eliminate carbon dioxide. It is defined by hypoxemia (PaO2 <60 mm Hg) or hypercapnia (PaCO2 >50 mm Hg) on arterial blood gas analysis. Respiratory failure is a common cause of death worldwide and a frequent problem in intensive care units. It can be acute or chronic and classified by blood gas levels, site of failure in the respiratory system, or onset. Causes include airway obstruction, lung disease, pulmonary vascular conditions, chest wall issues, and neuromuscular disorders. Treatment involves oxygen therapy, ventilation, secretion clearance, nutrition, and managing the underlying cause.
This document discusses pulmonary embolism (PE), including:
- PE occurs when blood clots (thrombi) block pulmonary arteries, ranging from acute massive PE to chronic PE.
- Deep vein thrombosis is the main cause of PE. Risk factors include recent surgery, oral contraceptive use, and malignancy.
- Symptoms can range from asymptomatic to sudden death. Common symptoms include dyspnea and chest pain.
- Diagnostic tests include CT pulmonary angiography, ventilation-perfusion scanning, echocardiography, and D-dimer levels. CT pulmonary angiography has high sensitivity and specificity for PE diagnosis.
This document provides an overview of pulmonary embolism (PE). It discusses the historical context, pathophysiology, risk factors, clinical presentation, diagnostic testing and treatment of PE. Some key points include:
- PE is a common cause of preventable death, with over 600,000 cases annually in the US.
- Virchow's triad of hypercoagulability, stasis, and endothelial injury contributes to the development of PE.
- Clinical presentation is often nonspecific, and the classic triad of symptoms occurs in less than 20% of cases.
- Diagnostic testing includes D-dimer, chest CT, ventilation-perfusion scanning and pulmonary angiography. Early treatment with antico
This document discusses the evaluation and management of chest pain. It begins with an overview of the magnitude of the problem, common causes of chest pain, and the recommended approach. Epidemiology data shows that chest pain is a common reason for emergency department visits. Only 15-20% of chest pain patients actually have acute coronary syndrome, while 10% have life-threatening non-cardiac causes like gastrointestinal issues. The document then covers the history, physical exam, investigations like ECG and biomarkers, and diagnostic approach for stable versus unstable patients. Common cardiac and non-cardiac causes of chest pain are reviewed along with their typical characteristics to help determine etiology.
UNIT 5.2 PHYSIOLOGICAL CONCEPTS AND PHYSICAL CHARACTERISTICS: Estrogens replacement therapy is commenced on the basis of dependent or previously estrogen sensitive women.
Low dose estrogens for short period to improve metabolic state. Estrogens therapy relieves unpleasant symptoms such as hot flashes and vaginal dryness and also appeared to protect against postmenopausal conditions such as osteoporosis and heart disease
A wound is a break or cut in the continuity of any body structure, internal or external caused by physical means.
A wound is a type of injury which happens relatively quickly in which skin is torn, cut, or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound).
This document discusses cell counts on cerebrospinal fluid (CSF) and other body fluids. It defines CSF and other serous fluids like pleural, pericardial, and synovial fluid. The analysis and clinical significance of CSF is explained, including how to perform cell counts, quality control measures, and sources of error. A normal CSF analysis includes a gross examination, cell count and differential count, and measurements of glucose and protein. An increased number of neutrophils in the CSF differential count indicates bacterial infection or meningitis.
This document discusses analysis of cerebrospinal fluid (CSF) and other body fluids. It defines CSF as the fluid found in the subarachnoid space of the brain, and explains that CSF is analyzed to diagnose conditions like meningitis. The document outlines the procedure for CSF analysis, including collecting CSF via lumbar puncture, examining its appearance, and performing cell counts and differentials. It also discusses the clinical significance of CSF analysis and quality control measures for body fluid examinations.
Cardiac catheterization involves inserting thin plastic tubes called catheters into arteries and veins in the heart to take X-ray images and measure pressures. It can be used for diagnostic or therapeutic purposes to evaluate conditions like coronary artery disease. The history of the procedure began in the 1920s and it has evolved with developments like balloon angioplasty. It involves accessing the arteries or veins to pass catheters into the heart chambers and coronary arteries to visualize structures and take measurements. Potential complications include infection, bleeding, reaction to contrast dye, and damage to blood vessels or heart. The procedure ends with removing the catheters and closing the arterial access point.
Pulmonary embolism (PE) is a common and potentially deadly condition where blood clots block the pulmonary arteries in the lungs. The document discusses the pathophysiology, risk factors, clinical presentation and diagnostic workup of PE. Treatment involves anticoagulation with heparin or warfarin to prevent further clotting. A simplified diagnostic algorithm is proposed utilizing pre-test probability, D-dimer testing and CT angiography to efficiently evaluate for PE.
This document discusses various pleural diseases and how to evaluate pleural effusions. It describes common causes of pleural effusions including congestive heart failure, liver cirrhosis, parapneumonic effusions, malignant effusions, and tuberculous effusions. Evaluation of pleural effusions involves thoracentesis and analysis of pleural fluid characteristics to determine if the effusion is a transudate or exudate. Further tests such as pH, cytology, cultures and biopsies may be needed to identify the underlying cause.
This document discusses endocarditis, including its clinical manifestations and diagnosis. It notes that fever occurs in 80% of patients, while nonspecific symptoms like weakness and weight loss are also common. Diagnosis involves meeting criteria outlined by the modified Duke criteria, which consider major and minor clinical factors as well as positive blood cultures and echocardiogram results. Common causative organisms include streptococci, enterococci, staphylococci and HACEK bacteria in 5-10% of community-acquired cases.
This document discusses endocarditis, including its clinical manifestations, causative organisms, diagnosis, and management. Some key points include:
- Fever, nonspecific symptoms, heart murmurs, and embolic phenomena are common clinical manifestations.
- Common causative organisms include streptococci, enterococci, staphylococci, and HACEK bacteria.
- Echocardiography plays an important role in diagnosis, with TEE being more sensitive than TTE.
- The modified Duke criteria are used to diagnose definite or possible endocarditis based on clinical and echocardiographic findings.
- Complications like perivalvular abscesses may require surgical intervention.
Sarcoidosis from head to toe: What the radiologist needs to knowAbhineet Dey
Sarcoidosis is a multisystem granulomatous disorder characterized by development of noncaseating granulomas in various organs.
Clinical features are often nonspecific, and imaging is essential to diagnosis.
Abnormalities may be seen on chest radiographs in more than 90% of patients with thoracic sarcoidosis. Symmetric hilar and mediastinal adenopathy and pulmonary micronodules in a perilymphatic distribution are characteristic features of sarcoidosis. Irreversible pulmonary fibrosis may be seen in 25% of patients with the disease.
Although sarcoidosis commonly involves the lungs, it can affect virtually any organ in the body.
Computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography/CT (PET/CT) are useful in the diagnosis of extrapulmonary sarcoidosis, but imaging features may overlap with those of other conditions.
Familiarity with the spectrum of multimodality imaging findings of sarcoidosis can help to suggest the diagnosis and guide appropriate management.
Pharmacotherapy of ischemic heart diseasetolcha regasa
This document provides an overview of ischemic heart disease (IHD). It defines IHD and divides it into stable angina and acute coronary syndrome (ACS), with ACS further divided into non-ST-segment elevation myocardial infarction (NSTEMI)/unstable angina (UA) and ST-segment elevation myocardial infarction (STEMI). The causes of ACS are also discussed, with plaque rupture being identified as the predominant cause in over 90% of patients. Clinical features, diagnostic workup, and treatment approaches for the different classifications of IHD are described.
This document provides an overview of ischemic heart disease (IHD). It defines IHD as a syndrome arising from an imbalance between oxygen supply and demand in the myocardium. IHD is broadly divided into stable angina and acute coronary syndrome (ACS). ACS includes non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina (UA), and ST-segment elevation myocardial infarction (STEMI). The document discusses the causes, pathogenesis, clinical features, diagnosis, and treatment of these IHD conditions.
Pulmonary embolism presenation by Henok OnchoHenok Oncho
A pulmonary embolism is a blockage in the lungs caused by a blood clot that forms elsewhere in the body and travels through the bloodstream. Symptoms include shortness of breath, chest pain, and anxiety. Diagnosis involves tests like CT scans, ventilation-perfusion scans, and pulmonary angiograms. Treatment focuses on anticoagulant medications like heparin to prevent further clotting and reduce the risk of additional embolisms. Nursing care monitors the patient's oxygenation status and educates them on preventing future clots.
Cerebral Air Embolism – A Rare Complication of Computed Tomography Guided Lun...BRNSSPublicationHubI
Thoracic lesions constitute a major chunk of the conditions presenting to a pulmonologist. They comprise a panorama of assorted etiologies ranging from benign lung lesions to aggressive malignancies. A tissue biopsy and its histopathological analysis is the gold standard for diagnosis. Computed tomography (CT)-guided lung biopsy is a safe and imminent tool for obtaining a tissue biopsy of underlying thoracic pathology. However, it has its own gamut of complications. The most common complications encountered include pneumothorax, hemorrhage, hemoptysis, iatrogenic infections, and sporadically air embolism. Cerebral air embolism is a fatal complication of CT-guided lung biopsy seen in a miniscule subset of patients. It requires urgent diagnosis and prompt therapy initiation. High-flow oxygen and hyperbaric oxygen therapy are usually helpful. Due to heterogeneous presentation, it usually remains undiagnosed. A high index of suspicion and early initiation of appropriate therapy can save precious lives. We hereby report a unique case of this rarefied complication.
Pleurisy is inflammation of the pleura, the thin lining of tissue that surrounds the lungs. It causes sharp chest pain that worsens with breathing. The document discusses the types, causes, symptoms, diagnosis, and treatment of pleurisy. The main causes are infections like pneumonia, tuberculosis, and viruses. Diagnosis involves chest x-rays, fluid analysis, and other tests. Treatment focuses on the underlying cause through antibiotics, anti-inflammatories, pain medication, and procedures to drain fluid from the lungs.
Pericarditis is an inflammation of the pericardium that commonly affects men aged 20-50. It has several causes including viral or bacterial infections, certain cancers, autoimmune diseases, or physical trauma. Symptoms include chest pain that increases with deep breathing or lying flat. Diagnosis involves electrocardiograms, echocardiograms, and blood tests. Treatment focuses on reducing inflammation with medications like aspirin, ibuprofen, or colchicine. Surgery may be required in severe cases to drain fluid or remove the pericardium.
Pulmonary embolism is a potentially deadly condition caused by blood clots in the lungs. It is difficult to diagnose due to non-specific symptoms. Imaging tests like CT scans and ventilation-perfusion scans are used to identify clots in the lungs. Prompt diagnosis and treatment are important to reduce the high mortality rate associated with untreated pulmonary embolism.
Respiratory failure occurs when the respiratory system fails to oxygenate blood and eliminate carbon dioxide. It is defined by hypoxemia (PaO2 <60 mm Hg) or hypercapnia (PaCO2 >50 mm Hg) on arterial blood gas analysis. Respiratory failure is a common cause of death worldwide and a frequent problem in intensive care units. It can be acute or chronic and classified by blood gas levels, site of failure in the respiratory system, or onset. Causes include airway obstruction, lung disease, pulmonary vascular conditions, chest wall issues, and neuromuscular disorders. Treatment involves oxygen therapy, ventilation, secretion clearance, nutrition, and managing the underlying cause.
This document discusses pulmonary embolism (PE), including:
- PE occurs when blood clots (thrombi) block pulmonary arteries, ranging from acute massive PE to chronic PE.
- Deep vein thrombosis is the main cause of PE. Risk factors include recent surgery, oral contraceptive use, and malignancy.
- Symptoms can range from asymptomatic to sudden death. Common symptoms include dyspnea and chest pain.
- Diagnostic tests include CT pulmonary angiography, ventilation-perfusion scanning, echocardiography, and D-dimer levels. CT pulmonary angiography has high sensitivity and specificity for PE diagnosis.
This document provides an overview of pulmonary embolism (PE). It discusses the historical context, pathophysiology, risk factors, clinical presentation, diagnostic testing and treatment of PE. Some key points include:
- PE is a common cause of preventable death, with over 600,000 cases annually in the US.
- Virchow's triad of hypercoagulability, stasis, and endothelial injury contributes to the development of PE.
- Clinical presentation is often nonspecific, and the classic triad of symptoms occurs in less than 20% of cases.
- Diagnostic testing includes D-dimer, chest CT, ventilation-perfusion scanning and pulmonary angiography. Early treatment with antico
This document discusses the evaluation and management of chest pain. It begins with an overview of the magnitude of the problem, common causes of chest pain, and the recommended approach. Epidemiology data shows that chest pain is a common reason for emergency department visits. Only 15-20% of chest pain patients actually have acute coronary syndrome, while 10% have life-threatening non-cardiac causes like gastrointestinal issues. The document then covers the history, physical exam, investigations like ECG and biomarkers, and diagnostic approach for stable versus unstable patients. Common cardiac and non-cardiac causes of chest pain are reviewed along with their typical characteristics to help determine etiology.
UNIT 5.2 PHYSIOLOGICAL CONCEPTS AND PHYSICAL CHARACTERISTICS: Estrogens replacement therapy is commenced on the basis of dependent or previously estrogen sensitive women.
Low dose estrogens for short period to improve metabolic state. Estrogens therapy relieves unpleasant symptoms such as hot flashes and vaginal dryness and also appeared to protect against postmenopausal conditions such as osteoporosis and heart disease
A wound is a break or cut in the continuity of any body structure, internal or external caused by physical means.
A wound is a type of injury which happens relatively quickly in which skin is torn, cut, or punctured (an open wound), or where blunt force trauma causes a contusion (a closed wound).
“Trauma” = Injury of one or more systems,that results in excessive bleeding and mayaffect the normal body functioning.
Defined as cellular disruption caused by anexchange with environmental energy that isbeyond the body's resilience.
This document discusses substance abuse, focusing on alcohol overdose and cannabis intoxication. It defines substance abuse and lists the most common substances abused, including alcohol and cannabis. For alcohol overdose, it describes the lethal dose, signs and symptoms, diagnosis involving breathalyzer or blood tests, and emergency management following CAB principles. For cannabis intoxication, it discusses lethal doses, causes of dependency and overdose, signs of dependency and overdose, diagnosis using urine tests, and general emergency management involving supportive care.
Poisoning is injury or death due to swallowing, inhalation, touching or injecting various drugs, chemical, venoms or gases.
Many substances such as drugs, carbon monoxide, food poisoning, organo-phosphorus are poison.
Poisoning can be an accident or a planned action.
Organophosphate poisoning is poisoning due to organophosphates (OPs). Organophosphates are used as insecticides, medications, and nerve agents.
Symptoms include increased saliva and tear production, diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion.
Other names: Organophosphate toxicity
Causes: organophosphates
Hypovolemic shock is a life-threatening emergency in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.
Hypovolemic shock is a dangerous condition that happens when suddenly lose a lot of blood or fluids from body. This drops blood volume, the amount of blood circulating in body. That’s why it’s also known as low-volume shock.
Heat stroke a core temperature ≥40°C accompanied by CNS dysfunction in patients with environmental heat exposure. This condition represents a failure of the body's ability to maintain thermoregulatory homeostasis.
Hemorrhage is the loss of blood escaping from the circulatory system.
Bleeding can occur internally, where blood leaks from blood vessels inside the body, or externally either through a natural opening such as mouth, nose, ear, urethra or anus or through a break in the skin.
Uncontrolled bleeding can rapidly lead to shock and death.
Excessive or uncontrollable bleeding, often caused by trauma, surgical or obstetrical complications, or the advanced stages of certain illnesses such as cirrhosis and peptic ulcer disease.
An airway obstruction is a blockage in any part of the airway.
The airway is a complex system of tubes that conveys inhaled air from nose and mouth into the lungs.
An obstruction may partially or totally prevent air from getting into lungs.
Acute upper airway obstruction is a life-threatening medical emergency.
This document provides information on emergency care and triage. It discusses the principles of emergency care which include providing care without delay and using triage to prioritize patients. Triage involves sorting patients into categories of emergent, urgent, and non-urgent based on the seriousness of their conditions. The document then describes the triage process in more detail, including the different color codes used to categorize patients and the criteria for each category. It also discusses the roles of triage team members and how to set up an effective triage system.
Emergency nursing is a nursing specialty in which nurses care for patients in the emergency or critical phase of their illness or injury.
While this is common to many nursing specialties, the key difference is that an emergency nurse is skilled at dealing with people in the phase when a diagnosis has not yet been made and the cause of the problem is not known.
The document provides information on the care of patients undergoing traction. It defines traction as applying a pulling force to part of the body. Traction is used to provide alignment, reduce muscle spasms, prevent deformities, provide immobilization, and increase space between opposing surfaces. The document outlines different types of traction including skin, skeletal, and manual traction. It discusses nursing responsibilities like ensuring comfort, preventing complications, educating patients, and promoting exercise and mobility.
Rheumatoid arthritis (RA) facts
Rheumatoid arthritis is an autoimmune disease that can cause chronic inflammation of the joints and other areas of the body.
It can affect people of all ages.
The cause of rheumatoid arthritis is not known.
In rheumatoid arthritis, multiple joints are usually, affected in a symmetrical pattern.
Paget disease is a chronic bone disorder that typically results in enlarged, deformed bones due to excessive breakdown and formation of bone tissue that can cause bones to weaken and may result in bone pain, arthritis deformities or fractures.
Osteomalacia is a bone condition caused by vitamin D deficiency or impaired mineralization. It results in soft, weakened bones due to incomplete mineralization of bone matrix. Symptoms include bone pain, tenderness, fractures, and muscle weakness. Diagnosis involves x-rays showing pseudofractures and bone biopsy showing excess osteoid tissue. Treatment focuses on calcium and vitamin D supplementation to promote bone mineralization. Nursing care includes education on diet, sunlight exposure, pain management, and monitoring for treatment effectiveness.
Osteoporosis is a chronic, progressive disease of multifactorial etiology.
It is most frequently recognized in particularly in elderly people and does occur in sexes, all races, and all age groups.
Osteoporosis is a preventable disease that can result in disturbing physical, psychosocial, and economic consequences.
Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro architectural deterioration of bone tissue.
This document provides information about osteomyelitis, including:
1) Osteomyelitis is an inflammation of bone caused by an infecting organism that may remain localized or spread through the bone. Common causes are bacteria or fungi entering through a break in the skin or spreading via blood.
2) It can be classified as acute (less than 2 weeks), subacute (2-6 weeks), or chronic (over 6 weeks) based on duration of symptoms. It can also be classified based on mechanism of infection such as exogenous (from outside trauma/surgery) or hematogenous (from another infectious site).
3) Staphylococcus aureus is the most common pathogen. Risk factors
Cancer is a disease of the cells in the body. The body is made up from millions of tiny cells. There are several types of oral cancers, but around 90% are squamous cell carcinomas originating in the tissues that line the mouth and lips.
Oral or mouth cancer most commonly involves the tongue.
Selective alpha1 blockers are Prazosin, Terazosin, Doxazosin, Tamsulosin and Silodosin majorly used to treat BPH, also hypertension, PTSD, Raynaud's phenomenon, CHF
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
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STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
As the world population is aging, Health tourism has become vitally important and will be increased day by day. Because
of the availability of quality health services and more favorable prices as well as to shorten the waiting list for medical
services regionally and internationally. There are some aspects of managing and doing marketing activities in order for
medical tourism to be feasible, in a region called as clustering in a region with main stakeholders groups includes Health
providers, Tourism cluster, etc. There are some related and affecting factors to be considered for the feasibility of medical
tourism within this study such as competitiveness, clustering, Entrepreneurship, SMEs. One of the growth phenomenon
is Health tourism in the city of Izmir and Turkey. The model of five competitive forces of Porter and The Diamond model
that is an economical model that shows the four main factors that affect the competitiveness of a nation and its industries
in this study. The short literature of medical tourism and regional clustering have been mentioned.
“Environmental sanitation means the art and science of applying sanitary, biological and physical science principles and knowledge to improve and control the environment therein for the protection of the health and welfare of the public”.The overall importance of sanitation are to provide a healthy living environment for everyone, to protect the natural resources (such as surface water, groundwater, soil ), and to provide safety, security and dignity for people when they defecate or urinate .Sanitation refers to public health conditions such as drinking clean water, sewage treatment, etc. All the effective tools and actions that help in keeping the environment clean come under sanitation. Sanitation refers to public health conditions such as drinking clean water, sewage treatment. All the effective tools and actions that help in keeping the environment clean and promotes public health is the necessary in todays life.
6. Introduction
A pulmonary embolism is a potential cardiovascular
emergency where a blood clot develops in a blood vessels
elsewhere in a body( most commonly from the legs), travels to
an artery fin lungs, and forms an occlusion(blockage) of the
artery.
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7. Definition
Pulmonary embolism (PE) refers to the obstruction of the
Pulmonary artery or one of its branches by a thrombus (or
thrombi)that originates somewhere in the venous system or
in the I
right side of the heart.
It can damage part of the lung due to restricted blood flow,
decrease oxygen levels in the blood, and affect other organs
as well. Large or multiple blood clots can be fatal.
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10. Incidence
Approximately 15% patients died, causing, contributing or
accompanying in hospital related to pulmonary embolism
for the past 40 years.
Recent large, contemporary observational studies of PE
have reported an overall 3 months mortality of 17% and an
hospital mortality of 31%when PE associated with
hypotension.
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15. Risk factors contd…
Certain disease states (combination of states,
coagulation Alterations, and venous Injury)
Heart disease (Heart failure)
Trauma ( Fracture of hip, pelvis, vertebra, lower
extremities)
Post operative state /postpartum period
Diabetes mellitus and COPD
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16. Other predisposing factors
Advanced age
Obesity
Pregnancy
Oral contraceptive use
Constrictive clothing
History of previous PE
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21. Pathophysiology contd..
1.When an emboli travel to the lungs, they lodge in the
pulmonary vasculature.
2.The size of emboli determine the location
Blood flow is obstructed, leading to decreased perfusion of the
section of the lung supplied by the vessel.
3. The client continues to ventilate the lungs portion, but
because the tissue is not perfused, resulting in hypoxemia.
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22. Pathophysiology contd..
4.If an embolus lodges in a large pulmonary vessel, it increases
proximal pulmonary vascular resistance, causes atelectasis, and
eventually reduces cardiac output.
5.The arterioles constrict because of platelet degranulation,
accompanied by a release of histamine, serotonin,
catecholamine and prostaglandins.
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25. Clinical manifestations
Clinical manifestations or symptoms depends on the size of
the emboli and the size and number of blood vessels
occluded. Most common manifestations are :
DYSPNEA is the most frequent symptom
Tachypnea (very rapid respiratory rate) is the most
frequent sign.
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26. Continue… ..
Chest pain is common and is usually sudden and pleurtic in
origin.
It may be substernal and may mimic angina pectoris
or may Myocardial infraction.
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27. Other symptoms include
Anxiety
Fever, Tachycardia, apprehension, cough,
diaphoresis, hemoptysis and syncope.
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28. Sign and symptoms according to size of
embolus
In massive emboli,
Shock
Pallor
Severe dyspnea
Crushing chest pain
Pulse is rapid and weak
Bp is low
ECG indicates right ventricular strain
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29. Sign and symptoms according to size of
embolus contd…
In medium sized emboli,
Pleuritic chest pain
Dyspnea
Slight fever
Productive cough with blood streaked sputum
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30. Sign and symptoms according to size of
embolus contd…
In small emboli,
Pulmonary hypertension
ECG and chest X- ray indicates right ventricular
hypertrophy
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33. Diagnostic evaluation contd…
1. History taking and physical examination
There always needs to be a high a level of
suspicion that a pulmonary embolus may be
the cause of chest pain or shortness of
breath.
The health care professional will take a
history of the chest pain, including its
characteristics, its onset, and any
associated symptoms that may direct the
diagnosis to pulmonary embolism
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34. Diagnostic evaluation contd…
It may include asking about risk factors for deep vein
thrombosis.
Coughing up blood sputum may be a sign of pulmonary
embolism.
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35. Diagnostic evaluation contd…
Physical examination will
concentrate initially on the
heart and lungs, since
chest pain and shortness
of breath may also be the
presenting complaints for
heart attack, pneumonia,
pneumothorax
(collapsed lung),
dissection of an aortic
aneurysm, among others.
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36. Diagnostic evaluation contd…
With pulmonary embolism, the chest examination is often
normal, but if there is some associated inflammation on
the surface of the lung , a rub may be heard.
The surfaces of the lung and the inside of the chest wall are
covered by a membrane (the pleura) that is full of nerve
endings.
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37. Diagnostic evaluation contd…
When the pleura becomes inflamed, as can occur in
pulmonary embolus, a sharp pain can result that is worsened
by breathing, so-called pleurisy or pleuritic chest pain.
The physical examination may include examining an
extremity, looking for signs of a DVT, including warmth,
redness, tenderness, and swelling.
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40. Diagnostic evaluation contd…
2.D- dimer blood test
This test detects the presence of a
protein produced when a blood clot
breaks down somewhere in the body. A
negative results is a good indicator that
a clot is not present. A positive result
suggests that clots, may be present, but
more testing is needed to confirm.
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41. Diagnostic evaluation contd…
3. ABGs analysis
A sudden drop in the blood
oxygen level may suggest a
pulmonary embolism.
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42. Diagnostic evaluation contd…
4.Coagulation profile
Additional blood work should include coagulation studies to
evaluate for a hyper coagulable state, if clinically indicated. A
prolonged prothrombin time or activated partial thromboplastin
time does not imply a lower risk of new thrombosis.
progression of DVT and PE can occur despite full therapeutic
anticoagulation in 13% of patients.
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45. Diagnostic evaluation contd…
6.Lungs scan
This test, called a ventilation perfusion scan, uses small
amount of radioactive material to study airflow( ventilation)
and blood flow ( perfusion) in the lungs.
First, patient inhale a small amount of radioactive material
while a special camera designed to radioactive substances
records air movement in lungs.
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46. Diagnostic evaluation contd…
Then a small amount of radioactive material is injected into
a vein via arm. Images taken after the injection show
whether patient have a normal or diminished flow of blood
to the lungs.
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47. Diagnostic evaluation contd…
7.Pulmonary angiogram
During this test, a flexible tube
( catheter is inserted into large
vein- usually in the femoral
vein- and threaded through the
heart’s right atrium and then
into pulmonary arteries. A
special dye is injected into the
catheter, and X-rays are taken
as dye travels along the arteries
in the lungs.
It also measure pressure in the
right side of the heart.
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48. Diagnostic evaluation contd…
8.Ultrasound
A noninvasive sonar test known as duplex venous USGs (
sometimes called duplex scan or compression ultra-
sonography) uses high-frequency sound waves to check for
blood clots in the lower limb veins.( thighs)
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49. Diagnostic evaluation contd…
9.Magnetic resonance imaging
MRI scans use radio waves and a powerful magnetic field to
produce detailed images of internal structures.
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50. Medical management
Because PE is often a medical emergency, emergency
management is of primary concern. After emergency measures
have been initiated and the patient is stabilized, the treatment
goal is to dissolve the existing emboli and prevent new ones
from forming.
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51. Emergency management
Massive PE is a life – threatening emergency
The immediate objective is to stabilize the
cardiopulmonary system.
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52. Emergency management consists of the
following actions:-
Oxygen is administered immediately to relive hypoxemia,
respiratory distress, and central cyanosis.
Establish IV Lines.
Vasopressors ,inotropic agents such as dopamine and anti
dysrhythmic agents may be indicated to support
circulation if the client is unstable.
Perfusion scan, Hemodynamic monitoring andABG.
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53. Contd…
Hypotension is treated by a slow infusions of
dobutamine.
Continue monitoring ECG
Blood is drawn for serum electrolytes, CBC etc
If clinical assessment and ABG analysis indicate the
need, the patient is intubated and placed on a mechanical
ventilator.
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54. Contd…
If the patient has suffered massive embolism and is
hypotensive, an indwelling urinary catheter is inserted to
monitor urinary output.
Small doses of IV Morphine or sedative are administered to
relive patient anxiety.
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55. General management
Measure are initiated to improve respiratory and vascular
status.
Oxygen therapy
Use of elastic compression stocking or intermittent pneumatic
leg compression devices reduces venous stasis.
Elevating the leg above the level of heart.
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59. Treatment may include a variety of
modalities
General measures to improve respiratory and vascular
status.
Anticoagulation therapy
Thrombolytic therapy
Surgical intervention
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60. Pharmacologic therapy
Anticoagulation therapy: (heparin, warfarin Sodium) has
traditionally been the primary method for managing acute deep
venous thrombosis and PE.
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61. Pharmacologic therapy contd…
Thrombolytic therapy: (urokinase, streptokinase, alteplase
and reteplase)
Thrombolytic therapy resolves the thrombi or emboli more
quickly and restores more normal Hemodynamic functioning
of the Pulmonary circulation, thereby reducing Pulmonary
hypertension and improving Perfusion, Oxygenation, and
cardiac output.
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62. Pharmacologic therapy contd…
Bleeding is a significant side effect. Contraindications to
Thrombolytic therapy include a CV
A within the past 2
months, or other active intracranial processes, active
bleeding, surgery within 10 days of the Thrombolytic
therapy, recent delivery or labor and sever hypertension.
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63. Pharmacologic therapy contd…
Before start Thrombolytic therapy, INR. PTT ,
HEMATOCRIT,AND PLATELET counts are obtained.
Heparin is stopped prior to administration of a
Thrombolytic therapy.
During therapy, all but essential invasive procedure are
avoidied because of potential bleeding.
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64. Surgical management
Pulmonary embolectomy
It is the emergency surgical removal of emboli which are
blocking blood circulation. It usually involves removal of
thrombi, and is then reffered to as thrombectomy.
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66. Vein filter
A catheter can also be used to position a filter Vein filter. A
catheter can also be used to position a filter in the body's main
vein called the inferior vena cava that leads from your legs to
the right side of the heart.
This filter can help keep clots from being carried into lungs.
This procedure is typically reserved for people who can't take
anticoagulant drugs or when anticoagulant drugs don't work
well enough or fast enough. Some filters can be removed when
they are no longer needed.
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68. Nursing management
Nursing assessment
Take history with emphasis on onset and severity of dyspnea
and nature of chest pain.
Examine the patient leg carefully.
Assess for swelling of leg, duskiness, warmth, pain on
pressure over gastrocnemius muscle, pain on dorsiflexon of
the foot( positive homan’s sign), which indicate
thrombophlebitis as source.
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69. Monitor respiratory rate may be accelerated out of proportion
to degree of fever and tachycardia.
Observe the rate of inspiration to expiration.
Percuss for resonance, dullness, and flatness.
Ascultate for friction rub, crackles, ronchi, and wheezing.
Ascultate heart; listen for splitting of second heart sound.
Evaluate results of PT/PTT tests for patients on
anticoagulants
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70. Nursing diagnosis
1. Ineffective breathing pattern related to acute increase in
alveolar dead air space and possible changes in lungs
mechanics from embolism.
2. Ineffective tissue perfusion(pulmonary) related to decresed
blood circulation.
3. Acute pain(pleuritic) related to congestion, possible pleural
effusion, possible lungs infraction.
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71. Nursing diagnosis contd…
4.Anxiety related to dyspnea, pain and prognosis of disease.
5.Risk for injury related to altered hemodynamic factors and
anticoagulant therapy.
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72. Nursing interventions
Correcting breathing pattern
Assess for hypoxia, headache, restlessness, apprehension,
cyanosis, behavioral changes.
Monitor vital signs, ECG, oximetery, and ABG analysis for
oxygenation.
Monitor patients response to IV fluids/vasopressors
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73. Nursing interventions contd..
Monitor oxygen therapy used to relieve hypoxemia.
Prepare patient for assisted ventilation when hypoxemia is
due to local areas of pneumo-constriction and abnormalities
of V/Q ratios.
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74. Nursing interventions contd..
Improving tissue perfusion
Closely monitor for shock decreasing blood pressure,
tachycardia, cool, clammy skin.
Monitor prescribed medications given to preserve right
ventricular filling pressure, increased BP.
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75. Nursing interventions contd..
Patient should be kept in bedrest to reduce oxygen demand
and risk of bleeding.
Monitor urinary output hourly, because there may be
reduced renal perfusion and decreased GFR.
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76. Nursing interventions contd..
Relieving pain
Watch patient for signs of discomfort and pain.
Ascertain if pain worsens with deep breathing and coughing:
auscultate for friction rub.
Give prescribed morphine, and monitor for pain relief and
signs of respiratory depression.
Position with head of bed slightly elevated( unless
contraindicated by shock) and with chest splinted for deep
breathing and coughing.
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77. Nursing interventions contd..
Evaluate patient for sign of hypoxia thoroughly when
anxiety, restlessness, and agitation of new onset are
noted, before administering as needed sedatives.
Consider physician evaluation when these signs are
present, especially if accompanied by cyanotic nail
beds, circumoral pallor, and increased respiratory rate.
7/24/2022 77
78. Nursing interventions contd..
Reducing anxiety
Correct dyspnea and relief physical discomfort.
Explain diagnostic prcedures and the patients role :correct
misconception.
Listen to patiet concers; attentive listening relieves anxiety
and reduces emotional distress.
Speak calmly and slowly.
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79. Patient education and health maintenance
Advise patient of the possible need to continue taking
anticoagulant therapy for 6 weeks up to an indefinite period.
Teach about the sign of bleeding, especiallyof gums, nose,
bruising, blood in urine and stools.
For patient on anti coagulants, instruct to sue soft
toothbrush, avoid shaving with blade razor, and avois
aspirin containing products. Notify health care provider of
bleeding and bruishing.
7/24/2022 79
80. Patient education and health maintenance
contd..
Warn against taking medications unless approved by health
care provider, because many drugs interact with
anticoagulants.
Instruct patient to tell dentist about taking an anticoagulant.
Warn against inactivity for prolonged periods or sitting with
leg crossed to prevent recurrence.
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81. Patient education and health
maintenance contd..
Warn against sports/activities that may cause injury to legs
and predispose to a thrombus.
Encourage wearing a medical alert bracelet identifying
patient on anti coagulant.
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83. Prevention of Pulmonary embolism
For patients at risk for PE, the most effective approach
for prevention is to prevent DVT (deep venous
thrombosis).
Active leg exercise to avoid venous stasis.
Early ambulation is necessary.
Use elastic compression stocking.
7/24/2022 83
85. References
Smeltzer.S.G. Bare.B.G. Hinkle.J.G. Cheezer K.H.(2010) “Brunner &
Suddarth’s Textbook of medical- surgical nursing”.volume 1. (12th
edition).New Delhi,Kluwer India. Pvt. Ltd. 2078/03/12 at 12:00 pm
Mandal G.N (2016) “A Textbook of Medical Surgical Nursing”. 5th
edition. Kathmandu.Makalu Publication House.2078/03/11 at 4:30 pm
2019. Mayo Foundation of Medical Foundation and Research.
Pulmonary embolism. https://www.mayoclinic.org@2021/06/25at
2pm.
October 23, 2018. pulmonary-embolism.
https://www.slideshare.net/GAMANDEEP@2021/06/25 at 2pm
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