Patho
o Collection of particulate matter (solids, liquids, or air) that enters venous
circulation & lodges in the pulmonary vessels
o Lg emboli obstruct pulmonary blood flow = reduced gas exchange, reduced
oxygenation, pulmonary tissue hypoxia, decreased perfusion, possibly death
o Most often occus when inappropriate clotting forms a VTE in a vein in legs/pelvis
& a clot breaks off & travels into R side of heart
o Clot then lodges in pulmonary artery
o Platelets collect on the embolus = release of substances that cause blood vessel
constriction
o Widespread pulmonary vessel constriction x pulmonary hypertension = impaired
gas exchange & tissue perfusion
o Deoxy blood moves into arterial circulation = hypoxemia
o Some patients may not have hypoxemia
o Major Risk Factors for VTE leading to PE
Prolonged immobility, central venous catheters, sx, obesity, advancing
age, conditions that increase blood clotting, hx of thromboembolism
o Increased Risk
Smoking, pregnancy, estrogen therapy, HF, stroke, cancer (lung or
prostate), trauma
o Fat, oil, air, tumor cells, amniotic fluid & fetal debris, foreign objects, injected
particles, and infected clots can enter a vein & cause PE
o Fat emboli from fracture & oil emboli from dx procedures injure blood vessels &
cause acute ARDS
o Septic clots often arise from a pelvic abscess, infected IV catheter, & injections of
illegal drugs
o Prevention
Passive & active ROM exercises
Ambulate pt soon after sx
Use antiembolism & pneumatic compression stockings & devices after sx
Evaluate pt for criteria indicating need for anticoag therapy
Avoid use of tight garters, girdles & clothing
Prevent pressure under popliteal space by placing pillow under knee
Perform a comprehensive assessment of peripheral circulation
Elevate affected limb 20 degrees or more above level of heart
Change position every 2h
Prevent injury to vessel lumen by preventing local pressure, trauma,
infection, or sepsis
Refrain from massaging legs
Do not cross legs
Administer px’d drugs
Teach pt to avoid activities resulting in Valsalva maneuver (holding breath,
bearing down, cough)
Version | latest |
Category | Exam (elaborations) |
Authors | qwivy.com |
Pages | 8 |
Language | English |
Comments | 0 |
Sales | 0 |
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