PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…
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Transcript of PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…
![Page 1: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/1.jpg)
PULMONARY EMBOLISM
Bianca Moses Fall 2013
![Page 2: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/2.jpg)
Think back to Willy Wonka’s chocolate river…
![Page 3: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/3.jpg)
Think back to Willy Wonka’s chocolate river…
Remember Agustus Gloob?
![Page 4: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/4.jpg)
Think back to Willy Wonka’s chocolate river…
Remember Agustus Gloob?
…and when his body clogged the pipe?
![Page 5: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/5.jpg)
Think back to Willy Wonka’s chocolate river…
Remember Agustus Gloob?
…and when his body clogged the pipe?
![Page 6: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/6.jpg)
Think back to Willy Wonka’s chocolate river…Agustus Gloob
Remember Agustus Gloob?
…and when his body clogged the pipe?
![Page 7: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/7.jpg)
Think back to Willy Wonka’s chocolate river…Agustus Gloob
Remember Agustus Gloob?
…and when his body clogged the pipe?
Giant Pipe
![Page 8: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/8.jpg)
Agustus Gloob
Giant Pipe
This is analogous to a
![Page 9: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/9.jpg)
Agustus Gloob
Giant Pipe
Pulmonary EmbolismThis is analogous to a
![Page 10: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/10.jpg)
Agustus Gloob
Giant Pipe
Pulmonary EmbolismThis is analogous to a PE
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Clot from body
Giant Pipe
Pulmonary EmbolismThis is analogous to a PE
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Clot from body
Pulmonary Artery
Pulmonary EmbolismThis is analogous to a PE
![Page 13: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/13.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 14: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/14.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 15: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/15.jpg)
Pulmonary Embolism
• Blood Clot
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 16: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/16.jpg)
Pulmonary Embolism
• Blood Clot• Broken off part of a tumor
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 17: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/17.jpg)
Pulmonary Embolism
• Blood Clot• Broken off part of a tumor• Marrow fat from a broken bone
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 18: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/18.jpg)
Pulmonary Embolism
• Blood Clot• Broken off part of a tumor• Marrow fat from a broken bone• Air
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 19: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/19.jpg)
Pulmonary Embolism
• Blood Clot• Broken off part of a tumor• Marrow fat from a broken bone• Air• Broken off arterial plaque
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 20: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/20.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 21: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/21.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
![Page 22: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/22.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Blood flow may be completely blocked causing sudden death.
![Page 23: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/23.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Blood flow may or partially blocked causing lung damage.
![Page 24: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/24.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Frequently these originate from a DVT
![Page 25: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/25.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Frequently these originate from a DVT
Deep Vein Thrombosis
![Page 26: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/26.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Frequently these originate from a DVT
Deep Vein Thrombosis
So frequently in fact
![Page 27: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/27.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Frequently these originate from a DVT
Deep Vein Thrombosis
So frequently in fact, they’re commonly both referred to together
![Page 28: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/28.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Frequently these originate from a DVT
Deep Vein Thrombosis
So frequently in fact, they’re commonly both referred to together… as a VTE
![Page 29: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/29.jpg)
Pulmonary Embolism
Simply put, it is a clot that lodged in the arteries of the lungs
Frequently these originate from a DVT
Deep Vein Thrombosis
So frequently in fact, they’re commonly both referred to together… as a VTE
Venous Thromboembolism
![Page 30: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/30.jpg)
Venous Thromboembolism
Do you have killer legs?
![Page 31: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/31.jpg)
Venous Thromboembolism
Do you have killer legs?
This was the message in a public
awareness campaign in the
USA to inform about VTE risk
factors
![Page 32: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/32.jpg)
Venous Thromboembolism
Do you have killer legs?
This was the message in a public
awareness campaign in the
USA to inform about VTE risk
factors
![Page 33: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/33.jpg)
Venous Thromboembolism
Do you have killer legs?
This was the message in a public
awareness campaign in the
USA to inform about VTE risk
factors
![Page 34: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/34.jpg)
Venous Thromboembolism
Do you have killer legs?
This was the message in a public
awareness campaign in the
USA to inform about VTE risk
factors
Do you always cross your legs at the knee?
![Page 35: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/35.jpg)
Venous Thromboembolism
Do you have killer legs?
This was the message in a public
awareness campaign in the
USA to inform about VTE risk
factors
Do you always cross your legs at the knee?
This impedes blood flow
![Page 36: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/36.jpg)
Do you have killer legs?
This was the message in a public
awareness campaign in the
USA to inform about VTE risk
factors
Do you always cross your legs at the knee?
This impedes blood flow
andVenous Thromboembolism
![Page 37: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/37.jpg)
Do you have killer legs?
Venous Thromboembolism
Remaining sedentary for extended periods of time can help a clot form…
![Page 38: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/38.jpg)
Do you have killer legs?
Venous Thromboembolism
Remaining sedentary for extended periods of time can help a clot form…
Ever heard of travelers thromboembolism?
![Page 39: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/39.jpg)
Do you have killer legs?
Venous Thromboembolism
Remaining sedentary for extended periods of time can help a clot form…
Ever heard of travelers thromboembolism?
It’s a thing
![Page 40: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/40.jpg)
Venous Thromboembolism
Do you have killer legs?
Remaining sedentary for extended periods of time can help a clot form…
it’s not as bad as not getting out of bed at all
![Page 41: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/41.jpg)
Venous Thromboembolism
Do you have killer legs?
Remaining sedentary for extended periods of time can help a clot form…
it’s not as bad as not getting out of bed at all
This is why we, as nurses, encourage early ambulation
![Page 42: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/42.jpg)
Venous Thromboembolism
Do you have killer legs?
Pregnant bellies press on veins in the pelvis slowing blood return from the legs
![Page 43: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/43.jpg)
Venous Thromboembolism
Do you have killer legs?
Pregnant bellies press on veins in the pelvis slowing blood return from the legs
…anything slowing down blood, is the
perfect
![Page 44: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/44.jpg)
Venous Thromboembolism
Do you have killer legs?
Pregnant bellies press on veins in the pelvis slowing blood return from the legs
…anything slowing down blood, is the
perfect environment for
![Page 45: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/45.jpg)
Venous Thromboembolism
Do you have killer legs?
Pregnant bellies press on veins in the pelvis slowing blood return from the legs
…anything slowing down blood, is the
perfect environment for clot formation
![Page 46: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/46.jpg)
Venous Thromboembolism
Do you have killer legs?
Pregnant bellies press on veins in the pelvis slowing blood return from the legs
…anything slowing down blood, is the
perfect environment for clot formation…as is
![Page 47: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/47.jpg)
Dehydration.
environment for clot formation…as is
![Page 48: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/48.jpg)
Dehydration. It concentrates your platelets…
environment for clot formation…as is
![Page 49: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/49.jpg)
Cancer.
![Page 50: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/50.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
![Page 51: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/51.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
As was described in the article:
![Page 52: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/52.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
As was described in the article: Pulmonary embolism caused by spontaneous migration of tumor thrombus of renal cell carcinoma: A report of two cases
![Page 53: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/53.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
As was described in the article: Pulmonary embolism caused by spontaneous migration of tumor thrombus of renal cell carcinoma: A report of two cases
Shimada, S., & Saito, H. (2012). Pulmonary embolism caused by spontaneous migration of tumor thrombus of renal cell carcinoma: A report of two cases. International Journal of Urology, 10, 277-278. doi: 10.1111/j.1442-2042.2011.02926.x
![Page 54: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/54.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
As was described in the article: Pulmonary embolism caused by spontaneous migration of tumor thrombus of renal cell carcinoma: A report of two cases
An intriguing finding from this piece was that, “Interestingly, tumor emboli do not necessarily develop into pulmonary metastasis.”
Shimada, S., & Saito, H. (2012). Pulmonary embolism caused by spontaneous migration of tumor thrombus of renal cell carcinoma: A report of two cases. International Journal of Urology, 10, 277-278. doi: 10.1111/j.1442-2042.2011.02926.x
![Page 55: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/55.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
![Page 56: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/56.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
![Page 57: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/57.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
![Page 58: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/58.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression
![Page 59: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/59.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
![Page 60: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/60.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
“Cell-supported coagulation was shown to be cell number dependent,
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
![Page 61: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/61.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
“Cell-supported coagulation was shown to be cell number dependent, defined by a logarithmic relationship
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
![Page 62: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/62.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
“Cell-supported coagulation was shown to be cell number dependent, defined by a logarithmic relationship that was consistent across all cell lines”
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
![Page 63: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/63.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
“Cell-supported coagulation was shown to be cell number dependent, defined by a logarithmic relationship that was consistent across all cell lines”
“Across a range of tumor sites, a consitent relationship is seen between procoagulant potential
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
![Page 64: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/64.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
“Cell-supported coagulation was shown to be cell number dependent, defined by a logarithmic relationship that was consistent across all cell lines”
“Across a range of tumor sites, a consitent relationship is seen between procoagulant potential and both cell number
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
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Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Tumors can turn on genes to express tissue factors (TF)
“Cell-supported coagulation was shown to be cell number dependent, defined by a logarithmic relationship that was consistent across all cell lines”
“Across a range of tumor sites, a consitent relationship is seen between procoagulant potential and both cell number and TF cell surface expression”
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
![Page 66: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/66.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
Welsh, J., Smith, J., Yates, K., Greenman, J., Maraveyal, A., & Madden, L. (2012). Tissue factor expression determines tumour cell coagulation kinetics.International Journal of Laboratory Hematology, 34, 396-402. doi: 10.1111/j.1751-553X.2012.01409.x
Tumors can turn on genes to express tissue factors (TF)
“Cell-supported coagulation was shown to be cell number dependent, defined by a logarithmic relationship that was consistent across all cell lines”
“Across a range of tumor sites, a consitent relationship is seen between procoagulant potential and both cell number and TF cell surface expression”
Welsh, Smith, Yates,
Greenman, Varaveyal and Madden found
that…
↑TF expression = ↑ Clots
![Page 67: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/67.jpg)
Cancer. Tumors break off and lodge in pulmonary arteries…
and tumors secrete pro-coagulant factors
With joint replacement surgery
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Cancer. Marrow breaks off and lodges in pulmonary arteries…
and tumors secrete pro-coagulant factors
With joint replacement surgery
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Cancer. Marrow breaks off and lodges in pulmonary arteries…
contributing to a PE
With joint replacement surgery
![Page 70: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/70.jpg)
Cancer. Marrow breaks off and lodges in pulmonary arteries…
contributing to a PE
With joint replacement surgery
Other risk factors include
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Venous Valve Malfunction.
Other risk factors include
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Acquired Thrombophilia.
Venous Valve Malfunction.
Other risk factors include
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Acquired Thrombophilia. Smoking.
Venous Valve Malfunction.
Other risk factors include
![Page 74: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/74.jpg)
Acquired Thrombophilia.
Supplemental Estrogen.
Smoking.
Venous Valve Malfunction.
Other risk factors include
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Atria
l Fib
rilla
tion.
Acquired Thrombophilia.
Supplemental Estrogen.
Smoking.
Venous Valve Malfunction.
Other risk factors include
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Atria
l Fib
rilla
tion.
Acquired Thrombophilia.
High Blood Pressure.
Supplemental Estrogen.
Smoking.
Venous Valve Malfunction.
Other risk factors include
![Page 77: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/77.jpg)
Atria
l Fib
rilla
tion.
Venous stasis.
Acquired Thrombophilia.
High Blood Pressure.
Supplemental Estrogen.
Smoking.
Venous Valve Malfunction.
Other risk factors include
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Atria
l Fib
rilla
tion.
Venous stasis.
Genetic Thrombophilia.
Acquired Thrombophilia.
High Blood Pressure.
Supplemental Estrogen.
Smoking.
Venous Valve Malfunction.
Other risk factors include
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Signs and Symptoms of PE
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Signs and Symptoms of PE
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain
• Worse with
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain
• Worse with • exertion
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain
• Worse with • exertion• deep breathing
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain
• Worse with • exertion• deep breathing• bending and stooping
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain
• Worse with • exertion• deep breathing• bending and stooping
• Does not go away with rest
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain Dyspnea
• Worse with • exertion• deep breathing• bending and stooping
• Does not go away with rest
SymptomTriad
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Signs and Symptoms of PE
Hemoptysis
Chest Pain Dyspnea
• Worse with • exertion• deep breathing• bending and stooping
• Does not go away with rest
Sudden and Unexplained
SymptomTriad
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Signs and Symptoms of VTE (DVT → PE)
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness• Low O2 Saturation
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness• Low O2 Saturation• Cyanosis
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness• Low O2 Saturation• Cyanosis• Rapid Breathing
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness• Low O2 Saturation• Cyanosis• Rapid Breathing• Rapid Heartbeat
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness• Low O2 Saturation• Cyanosis• Rapid Breathing• Rapid Heartbeat• Leg Pain
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness• Low O2 Saturation• Cyanosis• Rapid Breathing• Rapid Heartbeat• Leg Pain• Leg Discoloration
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Signs and Symptoms of VTE (DVT → PE)
• Wheezing• Lightheadedness• Low O2 Saturation• Cyanosis• Rapid Breathing• Rapid Heartbeat• Leg Pain• Leg Discoloration• Temperature difference between legs
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Wells Prediction Rule
Anticipating • Ruling Out • Detecting
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Wells Prediction Rule
Anticipating • Ruling Out • Detecting
Score of 3+,High DVT Probability
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Wells Prediction Rule
Anticipating • Ruling Out • Detecting
Score of 3+,High DVT Probability Score of 1-2, Moderate Probability
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Wells Prediction Rule
Anticipating • Ruling Out • Detecting
Score of 3+,High DVT Probability Score of 1-2, Moderate Probability Score of ≤0, Low Probability
![Page 104: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/104.jpg)
Anticipating • Ruling Out • Detecting
In a symptomatic patient
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Anticipating • Ruling Out • Detecting
In a symptomatic patientdifferentiating betweenright ventricular myocardial infarction
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Anticipating • Ruling Out • Detecting
In a symptomatic patientdifferentiating betweenright ventricular myocardial infarctionand pulmonary embolism
![Page 107: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/107.jpg)
Anticipating • Ruling Out • Detecting
In a symptomatic patientdifferentiating betweenright ventricular myocardial infarctionand pulmonary embolismis not a simple task
![Page 108: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/108.jpg)
Anticipating • Ruling Out • Detecting
In a symptomatic patientdifferentiating betweenright ventricular myocardial infarctionand pulmonary embolismis not a simple task
In an article titled Right Ventricular Myocardial Infarction and Pulmonary
Embolism Differential Diagnosis – a Challenge for the Clinician
![Page 109: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/109.jpg)
Anticipating • Ruling Out • Detecting
In a symptomatic patientdifferentiating betweenright ventricular myocardial infarctionand pulmonary embolismis not a simple task
In an article titled Right Ventricular Myocardial Infarction and Pulmonary
Embolism Differential Diagnosis – a Challenge for the Clinician
Ginghina, C., Caloianu, G., Serban, M., & Dragomir, D. (2010). Right ventricular myocardial infarction and pulmonary embolism differential diagnosis-a challenge for the clinician
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Anticipating • Ruling Out • Detecting
Dr.Ginghina finds that an exhaustive diagnostic regimen is necessary to definitively rule out, or rule in the condition responsible for PE-like symptoms
In an article titled Right Ventricular Myocardial Infarction and Pulmonary
Embolism Differential Diagnosis – a Challenge for the Clinician
Ginghina, C., Caloianu, G., Serban, M., & Dragomir, D. (2010). Right ventricular myocardial infarction and pulmonary embolism differential diagnosis-a challenge for the clinician
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Anticipating • Ruling Out • Detecting
Dr.Ginghina finds that an exhaustive diagnostic regimen is necessary to definitively rule out, or rule in the condition responsible for PE-like symptoms
A regimen comparable to these tests that follow
![Page 112: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/112.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays
![Page 113: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/113.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays
![Page 114: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/114.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests
![Page 116: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/116.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests
![Page 117: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/117.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate
![Page 119: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/119.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
![Page 123: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/123.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
• ECG
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
• ECG • D-Dimer test
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
• ECG • D-Dimer test
Sensitive
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
• ECG • D-Dimer test
Sensitive, but not specific
![Page 127: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/127.jpg)
Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
• ECG • D-Dimer test
Sensitive, but not specific
If Positive
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
• ECG • D-Dimer test
Sensitive, but not specific
Clot = yes
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Anticipating • Ruling Out • Detecting
• Chest X-Rays• Rule’s out conditions that mimic PE
• Blood tests• Full CBC• Erythrocyte Sed. Rate• Renal Function Tests• Liver Enzymes Panel• Electrolyte Screen• Blood gases
• ECG • D-Dimer test
Sensitive, but not specific
Clot = yesLocation = unknown
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Ventilation-Perfusion Scan
Anticipating • Ruling Out • Detecting
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Ventilation-Perfusion Scan
Anticipating • Ruling Out • Detecting
Inhale Radioactive material
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Ventilation-Perfusion Scan
Anticipating • Ruling Out • Detecting
Inhale Radioactive material and trace where it goes
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Ventilation-Perfusion Scan
Anticipating • Ruling Out • Detecting
Inhale Radioactive material and trace where it goes and more importantly,
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Ventilation-Perfusion Scan
Anticipating • Ruling Out • Detecting
Inhale Radioactive material and trace where it goes and more importantly, where it doesn’t
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Ventilation-Perfusion Scan
Anticipating • Ruling Out • Detecting
Inhale Radioactive material and trace where it goes and more importantly, where it doesn’t
Look for the same patterns
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Ventilation-Perfusion Scan
Anticipating • Ruling Out • Detecting
Inhale Radioactive material and trace where it goes and more importantly, where it doesn’t
Look for the same patterns
when radioactive material is
injected
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Spiral CT with contrast
Anticipating • Ruling Out • Detecting
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Pulmonary Angiogram
Anticipating • Ruling Out • Detecting
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Echocardiogram
Anticipating • Ruling Out • Detecting
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Echocardiogram
Anticipating • Ruling Out • Detecting
Right ventricular dilation
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Echocardiogram
Anticipating • Ruling Out • Detecting
Right ventricular dilation
Leftward shift of the
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Echocardiogram
Anticipating • Ruling Out • Detecting
Right ventricular dilation
Leftward shift of the
inter-ventricular septum
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MRI
Anticipating • Ruling Out • Detecting
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Drug Interventions
• Anticoagulants to prevent new clots
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Drug Interventions
• Anticoagulants to prevent new clots• Includes
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Drug Interventions
• Anticoagulants to prevent new clots• Includes• Warfarin (Coumadin)• Rivaroxaban (Xarelto)• Low Molecular Weight Heparin• and others…
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Drug Interventions
• Anticoagulants to prevent new clots• Includes• Warfarin (Coumadin)• Rivaroxaban (Xarelto)• Low Molecular Weight Heparin• and others…
• Takes a few days for full effect
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Drug Interventions
• Anticoagulants to prevent new clots• Includes• Warfarin (Coumadin)• Rivaroxaban (Xarelto)• Low Molecular Weight Heparin• and others…
• Takes a few days for full effect• Easy bleeding and bruising
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Drug Interventions
• Anticoagulants to prevent new clots• Includes• Warfarin (Coumadin)• Rivaroxaban (Xarelto)• Low Molecular Weight Heparin• and others…
• Takes a few days for full effect• Easy bleeding and bruising• No razors• Soft bristle tooth-brushes
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Drug Interventions
• Thrombolytics
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Drug Interventions
• Thrombolytics• Includes
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Drug Interventions
• Thrombolytics• Includes• Alteplase• Reteplase• Tenecteplase• and others ending in -plase…
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Drug Interventions
• Thrombolytics• Includes• Alteplase• Reteplase• Tenecteplase• and others ending in -plase…
• Should be administered within 60 minutes of thrombotic event
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Drug Interventions
• Thrombolytics• Includes• Alteplase• Reteplase• Tenecteplase• and others ending in -plase…
• Should be administered within 60 minutes of thrombotic event
• Can cause sudden and severe bleeding
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Drug Interventions
• Thrombolytics• Includes• Alteplase• Reteplase• Tenecteplase• and others ending in -plase…
• Should be administered within 60 minutes of thrombotic event
• Can cause sudden and severe bleeding• Use only in emergency situations
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Invasive Interventions
• Catheter Embolectomy
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
• Surgical Embolectomy
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
• Surgical Embolectomy• Emergency surgery to remove as many blood clots
as possible
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
• Surgical Embolectomy• Emergency surgery to remove as many blood clots
as possible• Typically used for large clots in central pulmonary
artery
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
• Surgical Embolectomy• Emergency surgery to remove as many blood clots
as possible• Typically used for large clots in central pulmonary
artery• Vein Filter
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
• Surgical Embolectomy• Emergency surgery to remove as many blood clots
as possible• Typically used for large clots in central pulmonary
artery• Vein Filter• Wire mesh device positioned in inferior vena cava
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
• Surgical Embolectomy• Emergency surgery to remove as many blood clots
as possible• Typically used for large clots in central pulmonary
artery• Vein Filter• Wire mesh device positioned in inferior vena cava• Catches clots before they reach the lungs
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Invasive Interventions
• Catheter Embolectomy• Uses a catheter to suction the clot out
• Surgical Embolectomy• Emergency surgery to remove as many blood clots
as possible• Typically used for large clots in central pulmonary
artery• Vein Filter• Wire mesh device positioned in inferior vena cava• Catches clots before they reach the lungs• Reserved for when medication isn’t indicated
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Assess the risk of VTE using Virchow’s triad:
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Assess the risk of VTE using Virchow’s triad: Hypercoagulability
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Assess the risk of VTE using Virchow’s triad:
Venous stasis
Hypercoagulability
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Assess the risk of VTE using Virchow’s triad:
Venous stasis
HypercoagulabilityVeno
us tra
uma
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Encourage early mobilization
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Encourage early mobilization
If they can’t walk, have them perform foot/leg exercises in bed
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Compression
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Compression• SCD
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Compression• SCD• TED Hose
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Compression• SCD• TED Hose• Knee length• Thigh length
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Administer Anticoagulants
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Administer Anticoagulants • Assess regularly for occult or overt bleeding
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Administer Anticoagulants • Assess regularly for occult or overt bleeding
• Bleeding gums• Nosebleeds• Black and tarry stools• Hematuria• Drops in BP
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Administer Anticoagulants • Warfarin Therapy
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Administer Anticoagulants • Warfarin Therapy
• Encourage pt to maintain a regular intake of vitamin K (ie.leafy greens)
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Administer Anticoagulants • Warfarin Therapy
• Encourage pt to maintain a regular intake of vitamin K (ie.leafy greens)
• Advise patient to not take any medications containing aspirin or NSAIDS
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Oxygen Therapy
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Oxygen Therapy• Administer to every pt suspected of PE
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Oxygen Therapy• Administer to every pt suspected of PE• Increased O2 promotes pulmonary
vascular dilatation
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Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Patient Education
![Page 187: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/187.jpg)
Nursing Considerations
In the journal Nursing Standard, Farley et al describes the nursing considerations for PE as follows:
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Patient Education• Remain Hydrated• Trio of symptoms• Avoid constrictive clothing• Exercise calf muscles frequently• Wear compression stockings for long hauls
![Page 188: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/188.jpg)
Nursing Considerations
Patient Education
![Page 189: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/189.jpg)
Nursing Considerations
Patient Education• Walk at least once an hour when sitting
![Page 190: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/190.jpg)
Nursing Considerations
Patient Education• Walk at least once an hour when sitting• Lose weight
![Page 191: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/191.jpg)
Nursing Considerations
Patient Education• Walk at least once an hour when sitting• Lose weight• Stop smoking
![Page 192: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/192.jpg)
Nursing Considerations
Patient Education• Walk at least once an hour when sitting• Lose weight• Stop smoking• Instate safety measure to avoid injury while on
anticoagulants
![Page 193: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/193.jpg)
Nursing Considerations
Patient Education• Walk at least once an hour when sitting• Lose weight• Stop smoking• Instate safety measure to avoid injury while on
anticoagulants• For patients with risk factors for atherosclerosis
and are concerned about PE, consider a vegan or vegetarian diet
![Page 194: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/194.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
![Page 195: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/195.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian diet
![Page 196: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/196.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
![Page 197: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/197.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Red Meat = ↑↑↑ in Carnitine
![Page 198: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/198.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Red Meat = ↑↑↑ in Carnitine &
![Page 199: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/199.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Red Meat = ↑↑↑ in Carnitine &
Carnitine
![Page 200: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/200.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Red Meat = ↑↑↑ in Carnitine &
![Page 201: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/201.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Human Digestive
Tract
Red Meat = ↑↑↑ in Carnitine &
![Page 202: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/202.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Human Digestive
Tract
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 203: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/203.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Human Digestive
Tract
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 204: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/204.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Human Digestive
Tract
TMAO
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 205: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/205.jpg)
Nursing Considerations
Patient Education
• For patients with risk factors for atherosclerosis and are concerned about PE, consider a vegan or vegetarian diet
A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Human Digestive
Tract
TMAO =Promotes atherosclerosis in humans
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 206: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/206.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine Carnitine
Red Meat = ↑↑↑ in Carnitine &
![Page 207: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/207.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine Carnitine
Red Meat = ↑↑↑ in Carnitine &
![Page 208: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/208.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
Carnitine
Red Meat = ↑↑↑ in Carnitine &
![Page 209: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/209.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
Carnitine
Vegan Digestive
Tract
Red Meat = ↑↑↑ in Carnitine &
![Page 210: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/210.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
Carnitine
Vegan Digestive
Tract
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 211: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/211.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
Carnitine
Vegan Digestive
Tract
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 212: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/212.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 213: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/213.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 214: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/214.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
![Page 215: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/215.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
↑↑↑ Carnitine
![Page 216: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/216.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
↑↑↑ Carnitine
![Page 217: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/217.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
↑↑↑ Carnitine
Vegan Digestive
Tract
![Page 218: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/218.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
↑↑↑ Carnitine
Vegan Digestive
Tract
![Page 219: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/219.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
↑↑↑ Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
![Page 220: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/220.jpg)
Nursing Considerations
Patient Education A study by the Cleveland Clinic explored the health benefits of a
vegan or vegetarian dietThey found that
Carnitine
Carnivore Digestive
Tract
↑↑↑ TMAO
Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Gut microbes do a conversion
Gut microbes do a conversion
Red Meat = ↑↑↑ in Carnitine &
↑↑↑ Carnitine
Vegan Digestive
Tract
↓↓↓ TMAO
Less atherosclerosis = Less chance of PE
![Page 221: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/221.jpg)
References
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Ambro, L. (2013, April 07). Cleveland clinic researchers discover new link between heart disease and red meat. Cleveland Clinic News Service, Retrieved from http://www.eurekalert.org/pub_releases/2013-04/cc-ccr040513.php
Dhamanaskar, K. P., Figueira, K. E., Jerome, S. C., & Yemen, B. L. (2013). Test Bolus Technique for Detection of Pulmonary Emboli at 64-Slice Multidetector Computed Tomography Angiography. Canadian Association Of Radiologists Journal, 64(3), 226-228. doi:10.1016/j.carj.2012.05.001
Farley, A., McLafferty, E., & Hendry, C. (2009). Pulmonary embolism: identification, clinical features and management. Nursing Standard, 23(28), 49-56.
Ginghina, C., Caloianu, G., Serban, M., & Dragomir, D. (2010). Right ventricular myocardial infarction and pulmonary embolism differential diagnosis-a challenge for the clinician
Headley, C. M., & Melander, S. (2011). When It May Be a Pulmonary Embolism. Nephrology Nursing Journal, 38(2), 127-152.
Husted, H., Otte, K., Kristensen, B., Ørsnes, T., Wong, C., & Kehlet, H. (2010). Low risk of thromboembolic complications after fast-track hip and knee arthroplasty. Acta Orthopaedica, 81(5), 599-605. doi:10.3109/17453674.2010.525196
Meetoo, D. (2013). Understanding and managing deep vein thrombosis. Nurse Prescribing, 11(8), 390-395.
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![Page 222: PULMONARY EMBOLISM Bianca Moses Fall 2013. Think back to Willy Wonka’s chocolate river…](https://reader038.fdocuments.us/reader038/viewer/2022110208/56649da95503460f94a97320/html5/thumbnails/222.jpg)
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Ostwanj, W., & Arabj, M. (2011). Alteration in pulmonary perfusion due to iatrogenic pulmonary vein stenosis: A mimicker of pulmonary embolism. Avicenna Journal of Medicine, 1, 58-60.
Perry, M. (2008). Knowing the early signs of pulmonary embolism. Practice Nursing, 19(12), 620-623
Smithburger, P. L., Campbell, S., & Kane-Gill, S. L. (2013). Alteplase Treatment of Acute Pulmonary Embolism in the Intensive Care Unit. Critical Care Nurse, 33(2), 17-27. doi:10.4037/ccn2013626
WELSH, J. J., SMITH, J. D., YATES, K. R., GREENMAN, J. J., MARAVEYAS, A. A., & MADDEN, L. A. (2012). Tissue factor expression determines tumour cell coagulation kinetics. International Journal Of Laboratory Hematology, 34(4), 396-402. doi:10.1111/j.1751-553X.2012.01409.x