NUR 254 Pulmonary Embolism

NUR 254 Pulmonary Embolism

• What is a pulmonary embolism?

Answer An obstruction of blood flow in part of pulmonary vascular system by an embolus

• What is a thromboemboli?

Answer An embolus that originates in the deep veins of the legs or pelvis

• What is the most common cause of PE?

Answer Thromboemboli

• What can be an embolus?

Answer Anything that blocks the flow of blood

• What is the process of hemodynamic consequences that occur because of a PE?

Answer

• Pulmonary vascular resistance increases because of the clot

• Right ventricle fails when workload exceeds capacity
• Cardiac output decreases
• Systemic blood pressure decreases
• Pt goes into shock

• What are the three classifications of PE?

Answer

• Massive

• Submassive 1 / 2

• Low risk

• What are the characteristics of a massive PE?

Answer

• Prolonged hypotension requiring pharmacological support

• Right and left ventricle dysfunction
• Shock and/or cardiac arrest

• What are the characteristics of submassive PE?

Answer

• Normal blood pressure

• Right ventricular dysfunction-evidenced by echocardiogram
• Myocardial necrosis indicated by elevated troponin I and elevated BNP

• What are the characteristics of low risk PE?

Answer

• Normal BP

• No right ventricular dysfunction, no elevated biomarkers (troponin or BNP)

• What are the expected ABG results of a pt with PE?

Answer

• Pt will present with respiratory alkalosis d/t hyperventilation

• This will eventually turn into respiratory acidosis d/t body overcompensation causing CO2

trapping

• What are dead space areas of the lung?

Answer Areas that are ventilated but not perfused

• What is a saddle embolism?
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