Karteikarten
HPA - PE
Karten in diesem Stapel (10)
- 1What is PE?A medical emergency in which an embolus occludes a pulmonary blood vessel
- 2Prevalence12500 people hospitalised for PE in Aus in 2012 - 2013
- 3Risk factorsVirchow's triad (sluggish venous return, abnormal coagulation, vessel wall damage)
Advancing age
Surgery
Hip/femur fracture
Immobilisation
MI/CHF
Obesity
Pregnant women/women on HRT or contraceptives - 4CausesGenerally caused by thrombi forming proximal to the popliteal or iliofemoral veins that break off to become emboli and travel up to the pulmonary arteries and occlude blood flow
- 5PathophysiologyThrombi often appear proximally to the popliteal and iliofemoral veins. -> these can break loose and become an embolus.
The embolus then moves freely until it reaches the pulmonary arterial system.
The impact of the PE depends on the extent of blood flow obstruction.
-Occlusion of a large pulmonary artery will result in sudden death. Gas exchange is so significantly reduced and cardiac output falls dramatically.
-Lung tissue infarction may occur due to occlusion of significant portion of pulmonary blood flow.
-Obstruction of a small segment of pulmonary circulation with no permanent injury.
-Chronic or recurrent small emboli with recurring symptoms. - 6Symptoms(depend on the size and location)
Dyspnoea
Pleuritic chest pain
Anxiety - sense of impending doom
Cough - can be haemoptysis
Sweating & clammy skin (less common) - 7What might the nurse hear/notice on resp/cardiac examination?Resp: crackles (rales) heard on auscultation. Person may appear cyanotic in severe cases
Cardiac: may hear S3/S4 gallop in severe cases - 8VitalsRR: tachypneic
HR: tachycardic
BP: can be normal/ low in severe cases
SpO2: may be reduced in severe occlusion
Temp: may be febrile - 9Relevant path/other tests (6)Plasma D-dimer levels - d-dimer is a fragment of fibrin formed during lysis of a blood clot (elevated levels indicate blood clot formation)
Chest CT with contrast used to diagnose PE
Lung scans including perfusion & ventilation scans may be used
ABGs usually show hypoxaemia
Coagulation studies are used to monitor the response to therapy. (activated partiat thromboplastin) aPTT is used to assess the intrinsic clotting pathway and the response to heparin therapy. - INR is used to assess the extrinsic clotting system and oral coag. With warfarin. - 10MedicationsEnoxaparin sodium (low molecular weight heparin)
Aspirin (for anticoagulant properties)
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- Der Nutzer hat seine Fachbereichs-Information gelöscht. Karteikarten am HPA - PE, erstellt von Gelöschter Nutzer am 09/06/2018.
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- Erstellt von Em J · 8 Jun 2018
- Kopiert von Em J · 9 Jun 2018
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