PULMONARY EMBOLISM AND ITS MANAGEMENTS.pdf

Definition, causes, risk factors, pathophysiology, signs and symptoms, diagnostic evaluation, management, surgical management, nursing management.

1. PREPARED BY DOLISHA WARBI

2. DEFINITION:
Pulmonary embolism (PE) is an obstruction of the pulmonary artery or one of its branches by a thrombus (or
thrombi) that originates somewhere in the venous system.
A pulmonary embolism (PE) is a blood clot in your lung that creates a blockage.
This happens when a clot in another part of the body (often your leg or arm) moves through your veins to your
lung. A PE restricts blood flow to your lungs, lowers oxygen levels in your lungs and increases blood pressure in
your pulmonary arteries.

3. CAUSES:
üSmall masses of infectious material.
üFat;It can be released into the bloodstream after some types of bone fractures, surgery, trauma, or severe burns.
üAir bubbles or substances that get into the blood from trauma, surgery, or medical procedures.
üTumors caused by rapidly growing cancer cells.
üAmniotic fluid.
üDVT in the upper body
üOlder than 50 years
RISK FACTORS:
üCancer and cancer therapy
üFamily history of blood clots or clotting disorders
üHeart disease
üHealth history of blood clots or clotting disorders
üLong-term use of birth control pills or estrogen therapy
üSurgery or injury (especially to the legs) or orthopedic surgery.
üObesity
üEnlarged veins in the legs (varicose veins)
üCigarette smoking
üSurgery or injury (especially to the legs) or
orthopedic surgery
üSituations in which mobility is limited, such as
extended bed rest, flying or riding long distances, or
paralysis

4. PATHOPHYSIOLOGY:
Shock
Decrease output and decrease blood pressure
Right side heart failure
Increased right side heart workload to maintain pulmonary blood flow
Increased pulmonary artery pressure
</Absent of blood flow
DVT in the legs or any other part

5. SIGNS AND SYMPTOMS:
•Sudden shortness of breath (most common)
•Chest pain (usually worse with breathing)
•A feeling of anxiety
•A feeling of dizziness, lightheadedness, or fainting
•Irregular heartbeat
•Palpitations (heart racing)
•Coughing and/or coughing up blood
•Sweating
•Low blood pressure
•You may also have symptoms of deep vein thrombosis (DVT), such as:
a)Pain in the affected leg (may happen only when standing or walking)
b)Swelling in the leg
c)Soreness, tenderness, redness, and/or warmth in the leg(s)
•Redness and/or discolored skin

6. DIAGNOSTIC EVALUATION:
ØPulse oximetry
ØChest x-ray.
ØPulmonary angiogram.
ØComputed tomography (CT or CAT scan).
ØMagnetic resonance imaging (MRI).
ØDuplex ultrasound (US). This type of vascular ultrasound is done to assess blood flow and the structure of the
blood vessels in the legs.
ØBlood tests
ØArterial blood gas
ØElectrocardiogram (EKG).
Pulmonary angiogram
Duplex ultrasound
Electrocardiogram (EKG)

7. MANAGEMENT:
§Anticoagulants and aspirin are often given to help prevent DVT.
§Oxygen therapy
§Anti-embolisms stocking or intermittent pneumatic leg compression devices
§Elevate the legs about the level of the heart.
SURRGICAL MANAGEMENT:
•Pulmonary embolectomy.
•Transvenous catheter embolectomy

8. NURSING MANAGEMENT:
ØMonitored vital sign.
ØMonitor any signs and symptoms of hypoxia, headache, weight loss, pallor, sinuses and behavioral changes.
ØMonitor patient response to intravenous fluid or vasopressor.
ØMonitor oxygen therapy of the patient.
ØAdministered the prescribed drugs to the patient.
ØIn case of post operative management provide care for the stoma.
ØMonitor patient dietary pattern.
ØEncourage minimal mobility, range of motion of the patient.
ØProvide comfortable position.

9. THANKS YOU