Care of Patients With Pulmonary Embolism Chapter 34 Care of Patients With Pulmonary Embolism What unit is this patient admitted to?

Pulmonary Embolism Collection of particulate matter—solids, liquids, air—that enters venous circulation and lodges in pulmonary vessels Usually occurs when blood clot from a VTE in leg or pelvic vein breaks off; travels through vena cava into right side of heart Refer to Chapter 34 and key points

Pulmonary Embolus Pulmonary embolism with infarction.

Risk Factors Prolonged immobilization Central venous catheters Surgery Obesity Advancing age Conditions that increase blood clotting History of thromboembolism Risk- refer to DVT risk- what are some of them?

Health Promotion & Illness Prevention Smoking cessation Weight reduction Increased physical activity If traveling or sitting for long periods, get up frequently and drink plenty of fluids Refrain from massaging/compressing leg muscles What do modifiable risks reversal help with physiologically regarding smoking, weight, physical activity?

Clinical Manifestations Respiratory Dyspnea, tachypnea, tachycardia, pleuritic chest pain, dry cough, hemoptysis Cardiac Distended neck veins, syncope, cyanosis, systemic hypotension, abnormal heart sounds, abnormal ECG Low grade fever, petechiae, flu-like symptoms What is the first intervention?

Laboratory Assessment ABGs Pulse oximetry Imaging assessment What will these show?

Nonsurgical Management Oxygen therapy (nasal cannula, mask) Continuous patient monitoring Obtain adequate venous access Continuous monitoring of pulse oximetry Drug therapy Anticoagulants Fibrinolytics All of these will be may implemented simultaneously…what needs to be monitored with anti-clotting therapy?