Question

Pulmonary embolism topic what is the pathopysiology

Potential Nursing Diagnosis (3 minimum)

Risk Factors (3 minimum)

Signs & Symptoms/Expected Findings (6 minimum

Laboratory Tests (3 minimum)

Diagnostic Procedures (2 minimum

Nursing Care (3 minimum

Client Education (3 minimum

Treatments: (3 minimum)

Potential complications: (3 minimum)

Answer 1

Pulmonary embolism.

Pathophysiology:-

-Pulmonary embolism occurs when deep venous thrombi detach and embolize to the pulmonary circulation.

-Pulmonary vascular occlusion occurs and impairs gas exchange and circulation.

- Various substances are released from clot surrounding area causing regional blood vessels and bronchioles to constrict.

- hemodynamic consequences are increased pulmonary vascular resistance leading to increase in pulmonary arterial pressure and in turn , an increase in right ventricular work to maintain pulmonary blood flow.

- when work load of right ventricle exceed its capacity, right ventricular failure occur leading to decrease output followed by a decrease in systemic blood pressure and the development of shock.

Potential nursing diagnosis-Impaired gas exchanged related to decrease pulmonary perfusion associated with obstruction of pulmonary arterial blood flow by the embolus as evidence by dyspnea, positive for Pulmonary Embolism, and abnormal pulse oximetry.

Risk factors for pulmonary embolism -

1- venous stasis.

2- varicose veins

3-Hypercoagulability

4-Injury.

5-prolonged embolisation

Sign and symptoms-

Most frequent symptoms- Dyspnea , Tachypnea, Chest pain.

Other symptoms- Anxiety, fever ,cough, hemoptysis,syncope.

Lab test for -1- D -dimer

2- arterial blood gas measurements

3-ventilation perfusion scan.

Diagnostic procedures for pulmonary embolism-

1-pulmonary angiography

2- chest xray

3-ECG

4-Doppler ultrasonography and venography.

Nursing management-

1-Minimising the risk of pulmonary embolism

2-Managing pain

3-Managing oxygen therapy.

Client education-

1- Take your medication at time exactly as instructed.dont miss the dose.Inform the health care provider in cse of missed dose.

2-Prevent risk of developing another clot. Watch for the sign of embolism.take anticoagulant on time.

3- awareness about bleeding risk- patients on anticoagulants are more likely to bleed easily while taking anticoagulants. Bleeding may develop in many areas, such as the nose or gums, excessive menstrual bleeding in women, bleeding in the urine or feces, bleeding or excessive bruising in the skin, or vomiting material that is bright red or looks like coffee grounds. In some cases, if there is internal bleeding, you may not notice right away. Bleeding inside the body can cause you to feel faint, or have pain in the back or abdomen. Call your healthcare provider right away if you have these symptoms. It's also important to call immediately if you have an injury that could cause internal bleeding, such as a fall or a car accident.

Treatment-

1- Anticoagulant therapy (heparin, warfarin)

2- Thrombolytic therapy (urokinase, streptokinase,alteplase)

3- surgical management- (pulmonary embolectomy, transeverse cathetor embolectomy)

Complications of pulmonary embolism are following-

1- sudden cardiac death

2- sevwrw hypoxemia

3-obsteuctive shock

4- cor pulmonale

5- Arryhthmias