Pulmonary embolism Flashcards
Who are people at great risk for a pulmonary embolism?
1- dehydrated
2- veinous stasis
3- has been taking BC pills
they all make your blood thick
How can a thrombus cause a P.E?
thick blood forms a thrombus, which dislodges and then goes into the lungs.
If you have a bunch of clots in the your lungs, they act like road blocks. Can volume/blood get passed that?
NO. so, you end up getting a build up of blood/volume
What’s the fancy name for high blood pressure in your lungs?
pulmonary hypertension
when you have those clots, can gas exchange occur? can oxygen get on the hemoglobin?
what does this do to your PaO2?
No! the clots are in the way.
- decreases which makes you hypoxic.
what is the first or #1 s/s of P.E?
hypoxemia
manifestation of hypoxemia?
shortness of breath, coughing, and increased respiratory rate
what is the blood test that is usually used to DX a pulmonary embolus?
what is the name of the scan that is done to dx it?
D- Dimer (it will tell if a clot is located anywhere in the body.. not just in lungs)
- VQ scan (ventilation perfusion scan) it looks at blood flow to the lungs. (it finds little tiny clots)
Your patient is going for a VQ scan. what should you tell them to remove? why?
to remove the jewelry from chest area because it can give a false positive result.
you have a post-op patient with an incision and the MD thinks the patient has had a P.E. Besides the fact that they are gasping for breath, they’re cyanotic, they tachycardic, their O2 sats are down. how do I know if drew a D-Dimer on that person, how do I know it will be positive?
the patient has an incision, which will induce clotting. so, drawing a D-Dimer on this patient won’t do you any good because they have to clot anyway, so the d-dimer result is gonna be positive and high.
so, it’s not the best test for this person, so don’t pick it. we do a spiral CT scan instead of the D-Dimer.
The number test that will tell you if you have clots in the lung is a ____ scan
spiral ct scan (if finds big clots in the lungs)
S/S:
Hemoptysis increased pulse chest pain (sharp stabbing) cxr (atelectasis) increased bp in lungs decreased po2 (put on 100% oxygen) fever/ increased WBC (due to inflammation)
when the blood pressure in the lungs go up, what happens to workload on the right side of the heart?
increases; could lead to right sided heart failure
Prevention:
-ambulate
-hydrate
- o2
- may have to put on ventilator
-
how can we watch for right ventricular failure in this patient?
monitor the CVP.(right atrial pressure) we can’t stick lines into the ventricles because that will can an arrythmia, so we gotta use the atrium.
if the CVP goes up really really high, this person is going into right ventricular failure. (due to increased preload in the atrium)
