Pulmonary Embolism Flashcards
1
Q
Pulmonary Embolism is
A
Obstruction of the Pulmonary Artery
2
Q
Risk Factors
A
• DVT
– Virchow’s triad
\+Venous stasis/prolonged
immobility
\+Vessel wall damage
\+Hypercoagulability
- Obesity
- Smoking
- Fracture (hip/leg)
- Major surgery/trauma
- Malignancy
3
Q
Types of PE
A
- Blood clot
- Fat embolus
- Air embolus
- Amniotic fluid
- Tumor particles
4
Q
Classifications
A
Massive, Submassive, Low risk
5
Q
Massive Classifications
A
– Profound hypotension
– R & L ventricular dysfunction
– Shock/cardiac arrest
6
Q
Submassive Classifications
A
– Normotensive
– R ventricular dysfunction
– Elevated cardiac markers
7
Q
Low-risk Classifications
A
– Normotensive/No ventricular dysfunction or elevation in cardiac markers
8
Q
Initial Clinical Manifestations
A
- Dyspnea
- Chest pain
- Tachypnea
- Tachycardia
9
Q
Submassive/Massive Clinical Manifestations
A
• R heart failure with JVD • Hypotension • Anxious/restless/confused • Hypoxia • Poor peripheral perfusion • Hemoptysis with pulmonary infarction
10
Q
Diagnosis
A
• Imaging
– CXR
– CT scan
• Laboratory testing
– D-dimer
– ABG
– Cardiac markers
11
Q
Medical Management
A
• Anticoagulation • IVC filters - prevent recurrence • Cautious fluid management • Hemodynamically compromised – Thrombolytics – Embolectomy – Vasoactive/inotropic support
12
Q
Nursing Assessment
A
• Oxygenation/Spo2 • Chest pain • VS • Labs – ABGs – Lactate – Coagulation studies – Cardiac markers • Urine output
13
Q
Nursing Actions
A
- Provide O2
- Elevate HOB
- Medication Management
- Fluid management
- Bleeding precautions
