EXAM 2 NUR 265
â— Pulmonary embolism: clot that travels to the lungs
â—‹ Risk factors
â– Prolonged immobility
â– Central venous catheter surgery
â– Obesity
â– Advancing age
â– Conditions that increase blood clotting (DIC)
â– Distort of thromboembolism
â– Smoking
â– Pregnancy
â– Hormonal birth control (estrogen therapy)
â– Heart failure
â– Stroke
â– Cancer
â– Trauma
â– Afib
â—‹ S/s:
â– Dyspnea - SUDDEN ONSET
â– Pleuritic chest pain (sharp, stabbing type pain on inspiration)
â– Crackles
â– Wheezes
â– Apprehension
â– Anxiety
â— Give O2
â– Restlessness
â– Impending doom
â– Cough (productive or dry)
â– Tachypnea
â– Pleural friction rub
â– S3 or s4 heart sound
â– Diaphoresis
â– Low grade fever
â– Petechiae (fat embolism , does not impede blood flow, causes actual
damage to the blood vessels) over chest and a axillae
â– If really big you can see EKG changes
â– hemoptysis - bloody sputum
â– Decreased Sao2
â– Sudden dyspnea and chest pain= immediately notify rapid response team
â—‹ Labs:
â– Hyperventilation (caused from pain and hypoxia) = respiratory alkalosis
(low paco2 <35>7.45) = blood shunting from right side to left
lOMoARcPSD|301 380 4
â—‹ Dx:
side without picking up O2 from the = respiratory acidosis (high paco2
>45, low PH <7 xss=removed xss=removed xss=removed xss=removed xss=removed>75 = complication)
â– 5-10 days (for 24 hours)
â– Protamine sulfate = antidote
â—‹ Then transferred to oral warfarin
â– Monitor INR (2.0-3.0)
â– Vitamin K = antidoteÂ