Pulmonary Embolism


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I. Pulmonary Embolism
It occurs when an artery in the lungs becomes blocked. The blockaged is because of the dislodged clot (embolus) that travels to the arterial blood supply of one of the lungs.
A. Causes of Clot Formation:
  • Surgical Procedures
  • Long Periods of Inactivity
  • Increased levels of clotting factors in the blood
  • Certain Medical Conditions (CA, MI)
  • Vein Injury

II. Signs and Symptoms
  • Sudden Shortness of Breath (Active or at Rest)

  • Hemoptysis
  • Tachycardia
  • Tachypnea
  • Wheezing
  • Cyanosis
  • Excessive Sweating
  • Weak Pulse
  • Anxiety
  • Syncope(Lightheadedness)
  • Fever
  • Dyspnea, Leg and Ankle Swelling, Dizziness, Chest Pain (Pulmonary Hypertension)

III. Diagnostic Procedures
  • Pulmonary Angiogram
  • Chest X-ray
  • Lung Scan/ Ventilation-Perfusion Scan (V/Q scan)
  • Spiral (Helical) CT Scan
  • D-dimer Blood Test

IV. Management
  • Anticoagulants (Heparin and Warfarin)
  • Thrombolytic Therapy (Streptokinase)
  • Vein Filter
  • Pulmonary Thrombectomy
  • Compression stockings

V. Complications
  • Pulmonary Hypertension
  • Cor Pulmonale (Enlarged Right Ventricle)

VI. Nursing Responsibility
  • Watch Out For Bleeding Tendencies (Heparin-Warfarin Therapy)
  • Ambulation (Post Surgery)
  • Promote Exercise
  • Encourage Fluid Intake

VII. Updates
  • Ultrasound Waves for DVT (Study conducted by Emory University - November 2008)
  • Fiber-Binding Thrombolytic Agent for Lesser Risk of Recurrence and Bleeding (Department of Radiology, Clinical Center, National Institutes of Health (NIH), Bethesda, Md. - January 2008)
  • Rapid Lysis” a Combination of Clot-Dissolving Drug and a Clot Removal Device (AngioJet® Rheolytic™ Thrombectomy System – March 2007)

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