Pulmonary Embolism Flashcards
List the symptoms of pulmonary embolism
pleuritic chest pain, dyspnoea, cyanosis, tachypnoea, anxiety, hemoptysis, diaphoresis, syncope, tachycardia, crackles, low-grade fever
describe pulmonary embolism
obstruction of blood flow in part of the pulmonary vascular system by an embolus
why would pulmonary embolism occur after a total hip replacement
PE can occur after THR due to immobility before, after and during surgery increasing risk of DVT due to pooling blood causing a clot, damage to a vein in the surgery triggering coagulation, hypercoagulation common after surgery
what causes diaphoresis in PE
systemic stress response stimulates SNS which causes sweating
why does pleuritic chest pain occur in PE
blockage in pulmonary vascular system results in reduced blood flow and inflammation, both contributing to chest pain
what causes hemoptysis in PE
the blood is a result of pulmonary tissue death due to blockage of blood flow or possible rupture of capillaries
what causes crackles to be heard on auscutlation in PE
crackles are caused by the flow of air through the damaged parts of the lung
list nursing interventions that would be implemented for a patient with PE and provide a rationale for each
1) Place Pt in Fowler’s position to facilitate max lung expansion, reduce pressure on R side of heart and diaphragm
2) Initiate O2 therapy to increase alveolar arterial oxygenation, reduce workload on heart and lungs, prevent hypoxia and improve cellular function
3) teach and encourage patient to perform deep breathing exercises to increase lung ventilation and oxygenation
4) administer pain relief to support lung ventilation and gas exchange
How would you evaluate Fowler’s position in a Pt with PE and provide a rationale for this
Monitor for improvements in RR, O2 saturation and comfort (eg WOB, chest pain) as position should enhance lung expansion and improve respiratory mechanics
How would evaluate O2 therapy as an intervention for PE and provide a rationale for this
Monitor for improvements in RR and O2 saturation as O2 should reduce respiratory distress and improve oxygen saturation of blood to increase function of organs and reduce organ stress
why does tachycardia occur in PE?
tachycardia occurs to maintain cardiac output and systemic perfusion as the heart may struggle to overcome the increased pulmonary vascular pressure leading to reduced preload in the left atrium, also supports perfusion and oxygen delivery
why might someone with PE experience syncope
decreased oxygenation and reduced perfusion of the brain
why might cyanosis occur in PE patient
extremely low oxygen levels in the blood causes by reduced gas exchange result in cyanosis
why might tachypnoea occur in PE patient
body’s CM to increase oxygen levels in the blood
why might PE patients experience anxiety/impending sense of doom
hypoxia, stress response and rapid onset of symptoms
