Pulmonary embolism is a serious and potentially life threatening condition. When the blood supply to the lungs gets clogged with a clot pulmonary embolism can happen. It can happen even in healthy people.
Sudden blockage of blood vessel artery in the lungs can cause pulmonary embolism. Usually it is a blood clot. Most cases the clots can be small but it can still damage the lungs. If the clots are big enough it can be deadly. Quick treatments will reduce the risk for future problems (Lung disease, 2011). Most common of the symptoms are sudden shortness of breath which are a sharp chest pain that is worse when you cough or take a deep breath, a cough that brings up pink and foamy mucus (Lung disease, 2011). Anxiousness, sweating, light headed, tachycardia or palpitations are some other general symptoms that can occur (Lung disease, 2011).
Most cases pulmonary embolism is caused by a clot that breaks loose and travels to the lungs. Having clots in deep veins like in deep vein thrombosis can cause pulmonary embolism (Lung disease, 2011). More than 300,000 people are affected by pulmonary embolism each year (Lung disease, 2011). Any diseases that can form a clot in the body can lead to pulmonary embolism. Some of the factors that can increase the risk for pulmonary embolism includes, being inactive for long periods of time. This mainly happens after surgery or major illness, sitting in long flights or cars (Lung disease, 2011). As mentioned in the article of lung diseases about pulmonary embolism, recent surgeries include legs, hips, belly and brain can cause formation of an embolus. Diseases such as cancer heart failure, stroke or severe infection are some other extra risk factors. Also being pregnant, having child birth especially via c-section. Taking birth control pills or hormone therapy and smoking are some more of the risk factors included. Also at risk for clots if older than 70 and extremely obese (Lung disease, 2011)
Diagnosis of this disease is hard because the symptoms are like the ones in pneumonia, heart attack and panic attack (Lung, 2011). A good physical assessments and history will most of time help diagnose the problem. The patient will undergo several tests to diagnose. Common tests include ultrasound, spiral CT scan, EKG, ECG, MRI (Lung disease, 2011).
Treatments mainly consist of anticoagulant therapy. Helps prevent new clots and keep existing clots from growing. According to lung diseases 2011, first the patient may start out with heparin, a blood thinner that works quickly. Then start on Coumadin, a blood thinner that is a pill. The patient may continue this therapy according to their condition (Lung disease, 2011). If the condition is severe, thrombolytics are used, which are clot busting medicines. These drugs dissolve the clots quickly, but the side effects are increased risk of serious bleeding (Lung disease, 2011). Some people cannot take blood thinners; even if they take clot busters they can form clots. As mentioned in lung diseases 2011, to prevent this problem they may have a filter put in large vena cava that carries blood from lower body to the heart. The vena cava filter prevents the clots from reaching the lungs. Once you have pulmonary embolism you are likely to have it again, based on article in lung diseases 2011. Blood thinners will help reduce the risk but serious bleeding is another side effect. Make sure the patient understand the safe administration of blood thinners and the need to keep up with regular blood tests (Lung diseases, 2011).
Article in lung diseases about pulmonary embolism, it gives some ways to reduce the risk they are 1) avoid sitting for long periods of time, get up and walk every hour or so, or flex the feet 2) get moving as soon as you can after surgery 3) when you travel drink extra fluids, avoid caffeine and alcohol 4) wear antiembolism stockings if you are at high risk 5) if you take blood thinners, take it according to doctor's order. In medscape reference about pulmonary embolism the author talks about the prognosis. Approximately 10% of patients who develop pulmonary embolism will die within an hour, 30% die from subsequently repeated embolism (Oullette, 2011).
In the article about nursing management of pulmonary embolism the primary concern is maintenance of airway, breathing and circulation. Prevention of clot formation is another most important measure to take (Ensure care plan, 2011). In high risk patients allow early ambulation after surgery, if condition permits. Active and passive range of motion exercises at least every 8 hours. Encourage adequate fluid intake and use of compression boots to increase venous return (Oullette, 2011). Patients who are at home on Coumadin should be reminded about avoiding foods high in vitamin K, like green leafy vegetables which counteracts the effects of it. Encourage patient to use soft tooth brush and electric razor for shaving to avoid serious bleeding (Ensure care plan, 2011). Instruct the client to assess their own skin everyday to check for bruises related to anticoagulant therapy. Also instruct them to let the doctors know before invasive dental procedures that you are on anticoagulants. Patients should be instructed to get immediate medical help if shortness of breath, leg swelling, and decreased pulses in lower extremities or anxiety occurs (Ensure careplan, 2011).
Pulmonary embolism is viewed as the most common missed diagnosis in the elderly. It can be life threatening but immediate treatment with anticoagulant agents can greatly reduce the risk of death.