Pulmonary Embolism

What is the primary pathophysiology of a pulmonary embolism (PE)?

A blood clot or mass obstructs the pulmonary artery or its branches, causing a ventilation-perfusion mismatch and increased pulmonary vascular resistance.

What are the three components of Virchow's Triad for PE risk factors?

Venous stasis, endothelial injury, and hypercoagulability.

What is the gold standard diagnostic test for pulmonary embolism?

Spiral CT with contrast (CTPA).

What is the clinical significance of a negative D-dimer test in suspected PE?

It is highly useful to rule out PE because of its high sensitivity.

What is the classic triad of symptoms often associated with PE?

Sudden dyspnea, pleuritic chest pain, and tachypnea.

What is the immediate nursing priority for a post-operative patient suspected of having a PE?

Apply oxygen, notify the provider, and position the patient in high Fowler's.

Why should you never massage the calf of a patient suspected of having a DVT?

Massage may dislodge the clot, potentially causing it to travel to the lungs as a PE.

What is the antidote for heparin?

Protamine sulfate.

What is the antidote for warfarin?

Vitamin K.

Which lab values are monitored for heparin and warfarin therapy?

aPTT for heparin; PT/INR for warfarin.

What is the primary nursing intervention to prevent PE in post-surgical patients?

Early ambulation.

What is the difference between pleuritic chest pain (PE) and crushing chest pain (MI)?

Pleuritic pain is sharp and worsens with inspiration, whereas MI pain is typically described as crushing or pressure-like.