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What is pulmonary embolism?

Pulmonary embolism is a condition caused by a thrombus formation that originates somewhere in the venous pulmonary-embolism-nursing-care-plansystem that detaches and lodges at the branch of pulmonary artery. It is not a disease in and of itself. Rather, it is a complication of underlying venous thrombosis (Ouellette, 2014). If left untreated, about 30 percent of patients who have PE will die. Most of those who die do so within the first few hours of the event (NIH, 2011).

Risk Factors

  • Prolonged immobilization
  • Prolonged periods of sitting and standing
  • Varicose veins
  • Vascular disease
  • Thrombophlebitis
  • Surgery
  • Injury
  • Tumors
  • Trauma
  • Congestive heart failure
  • Diabetes mellitus
  • Advanced age
  • Pregnancy
  • Oral Contraceptive Use
  • Obesity

Clinical Manifestations

  • Dyspnea – accompanied by angina and plueritic pain; exacerbated by inspiration
  • Chest pain
  • Cough
  • Hemoptysis
  • Tachypnea
  • Tachycardia
  • Cyanosis
  • Distended neck veins
  • Hypotension
  • Shallow respirations
  • Anxiety
  • Syncope

Laboratory and Diagnostic Findings

  • Chest X-ray- infiltrates, atlectasis, and elevation of the diaphragm; nonspecific
  • Arterial blood gas- hypoxemia and hypocapnia
  • ECG changes- sinus tachycardia, PR-interval depression and non-specific T-wave changes
  • Pulmonary angiography- arterial obstruction and perfusion deficit
  • Duplex ultrasonography- noninvasive diagnosis of pulmonary embolism by demonstrating the presence of a DVT at any site
  • MRI- pulmonary emboli demonstrate increased signal intensity within the pulmonary artery

Pulmonary Embolism Nursing Care Plan

References:

  • Anderson, F. & Audet, A.M. (2010). Preventing Deep Vein Thrombosis and Pulmonary 
  • Embolism: A Practical Guide to Evaluation and Improvement. Retrieved from www.outcomes-umassmed.org.
  • Black, J., & Hawks, J. (2009). Medical-surgical nursing: clinical management for positive outcomes (8thed.).St. Louis, Mo.: Saunders/Elsevier Inc.
  • Doenges, M.E., Moorhouse, M.F., and Murr, A.C. (2010). Nurse’s Pocket Guide. 
  • Philadelphia, Pennsylvania: F.A. Davis Company
  • Silvestri, L. A.(2005). Saunders Comprehensive review for the NCLEX-RN Examination. 
  • St. Louis, Mo.: Saunders/Elsevier Inc.
  • Smeltzer, S., Bare, B., Hinkle, J. Cheever, K. (2010). Brunner & Suddarth’s Textbook of Medical Surgical Nursing.Wolter Kluwer Health/ Lippincott Williams & Wilkins.

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Janine Eleonor V. Jambaro is a young nurse writer who has great passion for service. She believes that nurses can touch hearts and transform lives. By writing, she is able to inspire others and express thoughts, feelings and experiences.