PE

Question 1

Sign’s and symptom’s of PE?

Answer 1

• SOB
• Chest pain
• Cough
• Increased HR
• Decreased SpO2

Question 2

Pathophysiology of PE

Answer 2

1. Thrombus formation in peripheral circulation dislodges
2. Thrombus travels to pulmonary circulation, causing partial of complete obstruction in PA
3. Increased pressure in RV causes dilation and septal deviation to LV
4. LV preload reduced causing decreased CO
5. Systemic arterial hypotension leads to coronary hypo perfusion
6. RV hypoxia results causing schema and infarction
7. Further increased myocardial demand causes LV failure
8. Obstruction to blood flow in pulmonary capillary bed also results in VQ mismatch, worsening hypoxaemia

Question 3

Cause’s of PE

Answer 3

Caused by blood clot’s that travel from the legs, or rarely other part’s of the body

Risk factor’s:
- Disorders that promote blood clotting as a result venous stasis, decreased mobility, and pregnancy

Question 4

Nursing diagnosis

Answer 4

Impaired gas exchange r/t decreased lung perfusion

Ineffective breathing pattern’s t/t anxiety, fear, pain, hypoxia

Question 5

Assessment’s

Answer 5

• COLDSPA to assess location/severity of pain in the chest
• Posterior chest (IPPA)
• Peripheral vascular - colour, oedema, warmth, sensation

Question 6

PE nursing intervention’s, rationale and evaluation

Answer 6

Administer anticoagulants as prescribed, to prevent risk of developing another clot/embolus

Encourage regular mobilisation and change’s, to improve circulation and prevent formation of clots

Reassure and educate patient and family about PE and treatment options to reduce stress and anxiety