ATI Chapter 24 Pulmonary Embolism – Flashcards
Unlock all answers in this set
Unlock answersquestion
When a solid, gaseous or liquid substance enters venous ciruculation and forms a blockage in the pulmonary vasculature
answer
Pulmonary Embolism
question
Tumors, bone marrow, amniotic fluid, foreign matter, deep vein thrombosis
answer
Causes of emboli
question
Prevention rapid recognition and treatment
answer
Essential for a positive outcome of a PE
question
Smoking cessation, appropriate weight, physical activity, healthy diet, weight exercises, compression stockings, avoid sitting for long periods of time risk factors
answer
Prevention measures
question
Long-term immobility • oral contraceptive use • pregnancy • tobacco use • hypercoagulability • obesity • orthopedic surgery • heart failure or chronic atrial fibrillation • sickle-cell anemia • long bone fractures • advanced age • decreased activity levels
answer
Risk factors
question
Anxiety • feelings of impending doom • pressure and chest • pain upon inspiration and chest wall tenderness • dyspnea and air hunger
answer
Subjective data
question
Pleurisy • pleural friction rub • tachycardia • hypotension • tachypnea • adventitious breath sounds • heart murmur and S3 and S4 • diaphoresis • low grade fever • decrease oxygen saturation levels • cyanosis • petechiae • fluid and lungs
answer
Objective data
question
PaCO2 levels are low less than 35 to 45 mmHg • respiratory acidosis occurs
answer
ABG analysis
question
Elevated above expected reference range in response to clot formation and release of fibrin degradation products expected reference range is 0.43 - 2.33 micrograms per milliliters
answer
D dimer
question
Can show a large PE
answer
Chest x-ray
question
Show circulation of air and blood and the lungs and can detect a PE
answer
Ventilation perfusion scan
question
Most thorough tests to detect a PE but invasive and costly
answer
Pulmonary angiography
question
Informed consent • monitor vital signs anxiety and bleeding
answer
Nursing actions for pulmonary angiography
question
Administer oxygen • high Fowler's • IV access • administer meds • emotional support • monitor LOC and mental status
answer
Nursing interventions for PE
question
Enoxaparin (Lovenox) heparin, warfarin (Coumadin)
answer
Medications for PE
question
Prevent clots from getting larger or additional clots from forming
answer
Anticoagulants are used to
question
Assess for contraindications (active bleeding, peptic ulcer disease, history of stroke, recent trauma) monitor bleeding times • monitor side effects of anticoagulants thrombocytopenia, anemia, hemorrhage
answer
Nursing considerations for anticoagulants
question
Warfarin
answer
Prothrombin time (PT) and international normalized ratio (INR) used for:
question
Heparin
answer
Partial thromboplastin time for:
question
Dissolving blood clots and restore pulmonary blood flow
answer
Thrombolytic therapy is used for
question
alteplase (Activase) & streptokinase (Streptase)
answer
Examples of thrombolytic therapy
question
Known bleeding disorders • uncontrolled hypertension • active bleeding • peptic ulcer disease • history of stroke • recent trauma or surgery • pregnancy
answer
Contraindications for thrombolytic therapy
question
Surgical removal of embolus
answer
Embolectomy
question
Insertion of a filter to prevent further emboli from reaching the pulmonary vasculature
answer
Vena cava filter
question
Monitor for hypotension, tachycardia, cyanosis, jugular venous distention and syncope • assess for presence of S3 or S4 heart pounds • IV access • urinary output • IV fluid crystaloids • monitor ECG • pulmonary pressures • administer inotropic agents (milrinone [Primacor] dobutamine [Dobutrex] to increase myocardial contractility • vasodilators may be needed
answer
Nursing action for decreased cardiac output
