Term
| What is a Pulmonary Embolism (PE)? |
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Definition
| A clot lodges in a branch of the pulmonary artery, disrupting flow of blood to an area of the lungs. |
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Term
| What do many PEs start off as? |
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Definition
| DVTs in the iliac, femoral, or popiteal veins. A blood clot may also form in the rt ventricle and travel to the pulmonary artery. |
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Term
| What 3 predisposing factors that put a pt at risk for developing a PE? |
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Definition
1. Hypercoagulability
2. injury to the vascular endothelium
3. Venous stasis |
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Term
If an occlusion of more than 40% of the pulmonary vascular bed what pulmonary and hemodynamic consequences may occur?
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Definition
1. increased dead space
2. Bronchoconstriction (may hear wheezing)
3. Compensatory shunting
4. Pulmonary Hypertension |
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Term
| If a person has a PE what might you expect the PAOP (wedge pressure) to be? |
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Definition
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Term
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Definition
| tachycardia and tachypnea, dyspnea, pleuric chest pain, apprehension, fever, cough, hemoptysis, Rt ventricle failure, crackles in lungs, and syncope. |
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Term
| What lab values would you expect to see in a pt with PE? |
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Definition
Low PaO2, low PaCO2 (breathing fast)
and an elevated D-dimer |
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Term
| An ECG for a pt with PE may show what? |
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Definition
| New onset of A-Fib or RBBB |
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Term
| What is the scan done to determine there is a PE? |
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Definition
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Term
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Definition
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Term
| What prevention Strageties are performed? |
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Definition
| anticoagulation, scds, ted hose |
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Term
| What are 5 treatment strategies? |
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Definition
| prevention of recurrence, clot dissolution, reverse pulmonary hypertension, promote gas exchange, and prevent complication. |
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Term
| When giving Lovenox what labs are looked at and what are the desired values? |
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Definition
| PTT (1.5-2 times the normal) and INR (2-3) |
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Term
| What is the nurses first priority when caring for a pt with PE? |
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Definition
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Term
| What assessment data should you gather when caring for a pt with PE? |
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Definition
| vital signs, ABGs, Lab values (PTT and INR), auscultation of breath sounds, and assessment of extremities for DVT. |
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Term
| What are the 3 main nursing diagnoses for a pt with PE? |
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Definition
Impaired gas exchange r/t V/Q mismatching or intrapulmonary shunting.
Acute pain r/t transmission and perception of cutaneous, visceral, muscular, or ischemic impulses.
Risk for fluid volume deficit |
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