Pulmonary embolism
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Transcript of Pulmonary embolism
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Pulmonary EmbolismPulmonary Embolism
Natalie Bermudez, RN, BSN, MSNatalie Bermudez, RN, BSN, MSClinical Educator for TelemetryClinical Educator for Telemetry
Telemetry Course
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Pulmonary EmbolismPulmonary EmbolismStatisticsStatistics
Occurs in more than 600,000 patients annually in the U.S.
Contributes to 50,000 to 200,000 deaths per year
Two-thirds of patients with fatal cases will die within one hour of
presentation
(Woods et al, 2005, p.166)
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Pulmonary EmbolismPulmonary EmbolismStatisticsStatistics
The mortality rate for hospitalized patients with
PE has remained at approximately 15% over the
past 40 years.
(Woods et al, 2005, p.166)
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An obstruction of the pulmonary artery or
one o f its branches by a thrombus (or
thrombi) that originates in the venous
system or the right side of the heart.
Pulmonary EmbolismPulmonary Embolism
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Most common thromboembolic problem in patients with
heart failure
Also caused by fat, air, amniotic fluid or septic emboli
Pulmonary EmbolismPulmonary Embolism
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Risk Factors:Risk Factors:
DVT Atrial Fibrillation
CAD CHF
Hemostasis
Pulmonary EmbolismPulmonary Embolism
Risk Factors:Risk Factors:
Postpartum Postoperative
Oral Contraceptives
Obesity
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SIGNS & SYMPTOMS:SIGNS & SYMPTOMS:
Pulmonary EmbolismPulmonary Embolism
Dyspnea Chest Pain Hemoptysis Tachycardia Hypoxia
Anxiety Fever Cough Diaphoresis S/S of DVT
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Diagnostic EvaluationDiagnostic EvaluationPulmonary EmbolismPulmonary Embolism
Chest x-ray
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DIAGNOSTIC EVALUATION:DIAGNOSTIC EVALUATION:
CT Angiogram of Chest V/Q Scan D-dimer ABG’s
Peripheral Vascular Studies (etiology) EKG (etiology)
Pulmonary EmbolismPulmonary Embolism
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DIAGNOSTIC EVALUATION:DIAGNOSTIC EVALUATION:
D-dimerD-dimer
It is a fibrin degradation fragment
Occurs through fibrinolysis
Pulmonary EmbolismPulmonary Embolism
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DIAGNOSTIC EVALUATION:DIAGNOSTIC EVALUATION:
V/Q ScanV/Q Scan
Ventilation & Perfusion Scan
2-part Test
Pulmonary EmbolismPulmonary Embolism
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TREATMENT OF TREATMENT OF SYMPTOMS:SYMPTOMS:
Analgesics
Supplemental O2 Therapy
Pulmonary EmbolismPulmonary Embolism
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MEDICAL MANAGEMENT:MEDICAL MANAGEMENT:
Anticoagulant Therapy Thrombolytic Therapy
Bedrest Surgical Embolectomy
Pulmonary EmbolismPulmonary Embolism
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ReferencesReferencesHodgson, B. B., & Kizior, R. J. (2007). Saunders nursing
drug handbook. St. Louis, MS: Saunders Elsevier.
Skidmore-Roth, L. et al. (2007). Mosby’s nursing drug reference, (20th ed.). St. Louis, MS: Mosby Elsevier.
Smeltzer et al. (2008). Brunner and suddarth’s textbook of medical-surgical nursing, (11th ed.). Philadelphia, PA: Lippincott Williams and Wilkins.
Woods, S. L., Sivarajan Froelicher, E. S., Underhill Motzer, S., & Bridges, E. J. (2005). Cardiac Nursing (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.