Questions and Answers
What is the primary cause of pulmonary embolism?
Which of the following is NOT a common cause of pulmonary embolism?
What happens to the lung's surfactant production during a pulmonary embolism?
How does a thrombus contribute to pulmonary embolism?
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What is a potential consequence of a large embolus in the pulmonary vessels?
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Which type of emboli does pulmonary embolism include?
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Which factor is associated with venous stasis contributing to thrombus formation?
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What is the role of the right side of the heart in pulmonary embolism?
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Which symptom is commonly associated with pulmonary embolism?
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Which of the following is a potential complication of pulmonary embolism?
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What is an effective diagnostic test for pulmonary embolism?
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Which assessment finding indicates a high level of concern in a patient suspected of having pulmonary embolism?
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What should be avoided in the management of a patient with suspected pulmonary embolism?
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In the context of pulmonary embolism, what does the presence of hemoptysis indicate?
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What is an important part of collaborative management for a patient with pulmonary embolism?
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Which of the following is NOT a common symptom of pulmonary embolism?
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What is the primary anticoagulant therapy prescribed for a patient with pulmonary embolism in the initial management phase?
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What role does the vena cava filter play in the management of pulmonary embolism?
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During the collaborative management of pulmonary embolism, what is typically assessed through a perfusion scan?
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Which of the following is NOT a common nursing intervention for a patient with pulmonary embolism?
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What is the recommended duration for Coumadin therapy after the initial treatment of pulmonary embolism?
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What type of medication is Dobutamine, when prescribed in the management of pulmonary embolism?
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Which laboratory test is NOT typically included in the assessment for pulmonary embolism?
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What is the purpose of using thrombolytic therapy in the treatment of pulmonary embolism?
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What is the primary symptom of pulmonary embolism (PE)?
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Which of the following is NOT a recommended action when teaching a patient about PE precautions?
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What should nursing interventions include when monitoring a patient with suspected PE?
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Which of the following factors is commonly associated with the formation of blood clots leading to PE?
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Which statement regarding the diagnosis of PE is correct?
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What is a significant reason for the difficulty in diagnosing pulmonary embolism?
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Which of the following is a recommended practice to prevent additional clots in patients diagnosed with PE?
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What is a contraindicated behavior for patients at risk for pulmonary embolism?
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Study Notes
Overview of Pulmonary Embolism (PE)
- PE is an obstruction in the pulmonary artery or its branches, primarily caused by thrombus from the right side of the heart.
- Other embolic sources include air, fat, amniotic fluid, and sepsis.
Causes of Pulmonary Embolism
- Fat embolism and multiple trauma increase risk.
- Peripheral vascular disorders (PVDs) can contribute.
- Abdominal surgery, immobility, and conditions leading to hypercoagulopathy are significant risk factors.
Pathophysiology of Pulmonary Embolism
- Thrombus formation is due to vascular wall damage, blood stasis, or hypercoagulability.
- Trauma can lead to clot dissolution and changes in intravascular pressure.
- Fragmented thrombus can travel to the right side of the heart and the lungs via the pulmonary artery, potentially causing further fragmentation or dissolution.
- Occlusion of pulmonary arteries prevents surfactant production, leading to alveolar collapse and atelectasis.
- A large embolus can completely block pulmonary vessels, resulting in death.
Assessment Features
- Common symptoms include restlessness, shortness of breath (SOB), dyspnea, and tachypnea.
- Patients may experience stabbing chest pain, cyanosis, dilated pupils, and feelings of apprehension.
- Additional signs can include diaphoresis, dysrhythmias, hypotension, fever, hemoptysis, and syncope.
Potential Complications
- Serious complications include pulmonary infarction, pulmonary hypertension, and embolic extension.
- Other risks involve hepatic congestion, necrosis, pulmonary abscess, shock, ARDS, massive atelectasis, and right-sided heart failure.
- Ventilation-perfusion mismatch can occur, leading to increased mortality.
Diagnostic Tests
- Common tests include chest X-ray, lung scan, pulmonary angiography, ECG, ABG measurements, thoracentesis, and plasma D-dimer test.
Collaborative Management
- Immediate oxygen therapy is critical.
- Promote early ambulation and monitor obese patients; avoid leg massage.
- Pain relief and elevation of the head of the bed enhance patient comfort.
- Anticoagulation therapy involves heparin for two weeks, transitioning to Coumadin for 3-6 months.
- Thrombolytic therapy and surgical options like pulmonary embolectomy or vena cava filter placement may be indicated.
Nursing Interventions
- Administer prescribed medications; IM injections should be avoided.
- Monitor vital signs, respiratory status, and signs of DVT.
- Encourage incentive spirometry use to promote lung function.
Patient Education
- Do's: Observe for bleeding, use soft toothbrushes, consider contraceptive options, and wear antiembolism stockings.
- Don'ts: Avoid aspirin with Coumadin, restrictive leg clothing, prolonged immobility, smoking, and high-risk activities that can cause bruising.
Key Points
- PE is often a result of clots traveling from the legs to the lungs, leading to arterial blockage.
- Risk factors include sluggish blood flow, vessel injury, and clotting abnormalities.
- Sudden shortness of breath is the hallmark symptom of PE.
- Diagnosis can be challenging due to non-specific signs and symptoms; imaging studies aid in detecting PE.
- Treatment focuses on preventing further clots and may include medications, filters, or surgery.
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Description
This quiz covers the key aspects of pulmonary embolism, including its causes, pathophysiology, and potential sources of emboli. Understand the impact of thrombus formation and risk factors associated with PE. Test your knowledge on this critical topic in pulmonary health.
