NUR 265 Exam 2 Study Guide

Pulmonary Emboli (P 603) ● Occlusion of portion of pulmonary artery by a blood clot – from venous circulation – lower extremities or heart. ● Causes ventilation-perfusion mismatch (V/Q) – Ventilated alveoli no longer perfused due to clotted artery. ● Risk Factors o Venous stasis (w/prolonged immobility); Central venous catheters; Surgery (NPO, dehydrated, immobilized pts); Obesity; Advanced age; Hypercoagulability (Platelets >400K and not enough fluids; sticky blood); Hx of thromboembolism. o Greatest r/f in the young is the combo of smoking and hormone based contraceptives . ● Nursing Assessment Findings o Respiratory Classic Manifestations (Hypoxia drives all s/s) ▪ Dyspnea (sudden onset); Chest pain (sharp & stabbing); Apprehension, restlessness; Feeling of impending doom; Cough; Hemoptysis (blood in sputum). o Respiratory Signs ▪ Pleural friction rub (scratching sounds from pleura rubbing together & pain on deep inspiration); Tachypnea; Crackles (or normal); S3 or S4; Diaphoresis; Low grade fever; Petechiae over chest and axillae; Decreased arterial oxygen saturation (SaO2)