NURS 231 Final Exam Exam Questions with 100% Correct Answers

*Pulmonary Embolism Pathophysiology* (UNDERSTAND) Correct Answer a collection of particulate matter (solids, liquids, air) that enters venous circulation and lodges in the pulmonary vessels. Large emboli obstruct pulmonary blood flow, leading to reduced gas exchange, reduced oxygenation, pulmonary tissue hypoxia, decreased perfusion, and potential death. Any substance can cause an embolism a blood clot is the most common. Most commonly occurs from a DVT from a vein of the leg or pelvis where part of the clot breaks off and finds its way to the right side of the heart through the vena cava it then lodges in the pulmonary artery or one of its branches. This also means that blood cannot go through the left side of the heart to be perfused to the rest of the body. Platelets collect on the embolus, triggering the release of substances that cause blood vessel constriction causing impaired gas exchange and tissue perfusion Major Risk Factors for VTE leading to PE are: Correct Answer -prolonged immobility -central venous catheters -surgery -obesity -advancing age -conditions that increase blood clotting -history of thromboembolism -smoking -pregnancy -estrogen therapy -heart failure -stroke -cancer -trauma *Prevention of Pulmonary Embolism* Correct Answer -Start passive and active range of motion exercises for the extremities of immobilized and postoperative patient's. -Ambulate patient's soon after surgery -Use anti embolism and pneumatic compression stockings and devices after surgery. -Evaluate patient for criteria indicating the need for anticoagulant therapy. -Avoid the use of tight garters. Girdles, and constricting clothing. -Prevent pressure under the popliteal space -Perform comprehensive assessment of peripheral circulation. -Elevate the affected limb 20 degrees or more above the level of the heart to improve venous return, as appropriate. -Change patient position every 2 hours. -Prevent injury to the vessel lumen by preventing local pressure trauma, infection, or sepsis -Refrain from massaging leg muscles -Instruct patient not to cross legs -Administer prescribed prophylactic low-dose anticoagulant and anti platelet drugs -Teach patient to avoid activities that result in the Valsalva maneuver -Adminiter prescribed drugs, such as stool softener so, that will prevent episodes of the Valsalva Maneuver -Teach patient and family about precautions -Encourage smoke cessation (tobacco use narrows blood vessels and increases the risk for clot formation) -Hormone-based contraceptives increase blood clotting Hemoptysis Correct Answer blood sputum Syncope Correct Answer fainting or loss of consciousness Pulmonary Embolism Key Features Correct Answer *It is important to remember that many patients with PE do not have the "classic" symptoms.* Classic Symptoms: -Dyspnea, sudden onset -Sharp/stabbing chest pain -Apprehension, restlessness -Feeling of impeding doom -Cough -*Hemoptysis* Signs: -*Pleuritic chest pain* -*Dry Cough* -Tachypnea -Crackles -Pleural Friction Rub -Tachycardia -S3 or S4 heart sound -Diaphoresis -Low grade fever -Petechia over chest and axillae -Decreased arterial oxygen saturation (SaO2) Cardiac Symptoms from Pulmonary Embolism Correct Answer -Tachycardia -Distended neck veins -Syncope -Cyanosis -Hypotension