Pulmonary Embolism
As a rule, pulmonary embolism can be caused by a blood clot. This condition is especially severe in elderly people and discreet in children. Pulmonary embolism is usually treated with anti-coagulants, however, in more severe cases, other medication can be used. Anti-coagulants can be used to prevent this disease as well (Tapson, 2021). PE is reported to have incidence of 39-115 cases per 100 000 (Aertzteblatt, 2021)
Prevalence
The majority of pulmonary emboli are caused by the thrombi in the veins of the legs. They can form in chest or arm veins as well. However, there are other sources that can cause this condition, such as tumors, fat, infection, et cetera. Moreover, specific kinds of cancers can contribute to the risks of blood clots (MayoClinic, n. d.). According to recent data, COVID-19 has been known to increase the risk of pulmonary embolism (Tapson, 2021).
Pathophysiology
Catastrophic risk is defined by ventricular function impairments accompanied by hypotension. Massive risk is demonstrated either by systolic blood pressure or a drop in it. Submassive risk is defined by impairments in the right ventricular function or troponin/BNP levels without low blood pressure (Tapson, 2021). In low risk cases, patients usually lack hypotension and impaired right ventricular function. PE causes a blockage in the lungs, thus leading to oxygen starvation (Sharecare, n.d.).
Symptoms
The defining symptom, sometimes even the only one, is shortness of breath. Generally, such patients breathe very rapidly and may struggle with restlessness or anxiety. Other symptoms may include chest pains, irregular and/or rapid heartbeat. In some cases, people with this condition may either feel light-headed or lose consciousness (Tapson, 2021). During dangerously low hypotension, the patient may have cyanosis and suddenly die. Older people with pulmonary embolism may be confused or struggle with the deterioration of mental capacities.
Diagnosis
Hypoxemia is one of the symptoms of pulmonary embolism that requires a detailed review, which is why pulse oximetry may assist in diagnosing PE. People without hypoxemia may require blood gas testing, especially if they have tachypnea or dyspnea. Arterial blood gas measurement can reveal hypocapnia in some patients (Tapson, 2021). ECG usually demonstrates conditions that are atypical for this disorder. Chest X-rays can be used for diagnosing pulmonary embolism as well.
Nursing care
In order to assist patients with pulmonary embolism, nurses may take specific measures which include monitoring thrombolytic and oxygen therapy, preventing venous issues (Belleza, 2021). One should note that PE may be caused by genetic variants of Factor V Leiden and protothrombin (CDC, n.d.). In order to receive more information about the patient’s condition, it is required to discuss any concerns or struggles related to their case of PE.
Educating patients
Patients need to be well-informed about every aspect of this disorder. One needs to discuss risks and complications, while asking about prior medical history (Tapson, 2021). However, one’s religious and spiritual beliefs are to be considered (Swihart, 2021). That way, treatment can eventually become more effective and inclusive. If they have negative habits that may deteriorate their condition, it is best to warn them of the consequences of such actions.
Pulmonary embolism in children
As a rule, children’s cases of pulmonary embolism are misdiagnosed due to a number of factors. The symptoms of PE in children differ from adults’ symptomatology and this condition normally presents itself as silent. Children with high-risk conditions such as obesity and other pulmonary issues require a high index of suspicion (Zaidu, 2017). Unfortunately, most diagnostic tools are targeted towards adults, thus, they haven’t been validated for younger patients.
Prognosis
For an approximate definition of the prognosis, doctors need to review factors, such as blood pressure, oxygen level, required medication and heart rate. Elderly patients and people struggling with other pulmonary or cardiovascular issues are more likely to die of PE (Tapson, 2021). However, a person who does not have any lung or heart problems may successfully recover from this condition, if half of the pulmonary arteries are not blocked.
Prevention
Bedbound patients are more likely to be diagnosed on time, prior to any possible deterioration. However, if a specific patient has pulmonary or cardiovascular problems, it is important to review their status. Obesity and poor physical activity can contribute to the risks of pulmonary embolism, thus, patients need to monitor their way of life (Tapson, 2021). Doctors should pay closer attention to individuals with a history of prior PE cases for further evaluation.
References
Belleza, M. (2021). Pulmonary Embolism. Nurseslabs Genetic tests for idiopathic venous thromboembolism: EGAPP recommendation (n. d.) Centers for Disease Control and Prevention. Web.
How pulmonary embolism affects the body (n. d.) ShareCare. Web.
Kulka H. C., Zeller A., Fornaro J., Wuillemin W. A., Konstantinides S., Christ M. (2021) Acute pulmonary embolism—its diagnosis and treatment from a multidisciplinary viewpoint. Dtsch Arztebl Int; 118: 618–28.
Pulmonary embolism (n. d.). MayoClinic. Web.
Swihart D. L., Yarrarapu S. N. S., Martin R. L. (Nov, 2021). Cultural religious competence in clinical practice. StatPearls.
Tapson, V. F. (June, 2021). Pulmonary Embolism (PE). MSDManual Consumer Version
Tapson, V. F. (June, 2021). Pulmonary Embolism (PE). MSDManual Professional Version.
Zaidi, A. U., Hutchins, K. K., &Rajpurkar, M. (2017). Pulmonary Embolism in Children. Frontiers in Pediatrics, 5, 170. Web.