EXAM 2 NUR 265 ● Pulmonary embolism: clot that travels to the lungs ○ Risk factors ■ Prolonged immobility ■ Central venous catheter surgery ■ Obesity ■ Advancing age ■ Conditions that increase blood clotting (DIC) ■ Distort of thromboembolism ■ Smoking ■ Pregnancy ■ Hormonal birth control (estrogen therapy) ■ Heart failure ■ Stroke ■ Cancer ■ Trauma ■ Afib ○ S/s: ■ Dyspnea - SUDDEN ONSET ■ Pleuritic chest pain (sharp, stabbing type pain on inspiration) ■ Crackles ■ Wheezes ■ Apprehension ■ Anxiety ● Give O2 ■ Restlessness ■ Impending doom ■ Cough (productive or dry) ■ Tachypnea ■ Pleural friction rub ■ S3 or s4 heart sound ■ Diaphoresis ■ Low grade fever ■ Petechiae (fat embolism , does not impede blood flow, causes actual damage to the blood vessels) over chest and a axillae ■ If really big you can see EKG changes ■ hemoptysis - bloody sputum ■ Decreased Sao2 ■ Sudden dyspnea and chest pain= immediately notify rapid response team ○ Labs: ■ Hyperventilation (caused from pain and hypoxia) = respiratory alkalosis (low paco2 <35>7.45) = blood shunting from right side to left lOMoARcPSD|301 380 4 ○ Dx: side without picking up O2 from the = respiratory acidosis (high paco2 >45, low PH <7 xss=removed xss=removed xss=removed xss=removed xss=removed>75 = complication) ■ 5-10 days (for 24 hours) ■ Protamine sulfate = antidote ○ Then transferred to oral warfarin ■ Monitor INR (2.0-3.0) ■ Vitamin K = antidote