Pulmonary Embolism Stokke N180

1.

A pulmonary embolism is ______________________________.

A.

A clot from somewhere else that is lodged in the lungs obstructing blood flow through pulmonary vasculature.
B.

A clot that formed in the lung that obstructs pulmonary vasculature.
C.

A clot of any origin (inside or outside the lung) that lodges in the lung obstructing pulmonary vasculature.

Correct Answer
A. A clot from somewhere else that is lodged in the lungs obstructing blood flow through pulmonary vasculature.

Explanation
A pulmonary embolism is a condition where a clot from another part of the body, such as the legs, travels to the lungs and gets stuck, blocking the blood flow through the pulmonary vasculature. This can lead to serious complications and can be life-threatening if not treated promptly.

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2.

An imbalance between the supply of blood and the supply of air to the lungs is called ____________________.

A.

Serum-oxygen imbalance
B.

Hematoperfusion imbalance
C.

Ventilation-perfusion mismatch

Correct Answer
C. Ventilation-perfusion mismatch

Explanation
Ventilation-perfusion mismatch refers to an imbalance between the amount of air reaching the alveoli (ventilation) and the amount of blood reaching the alveoli (perfusion) in the lungs. This can occur due to various factors such as blockages in the airways or blood vessels, lung diseases, or conditions that affect the distribution of blood flow in the lungs. It can lead to impaired gas exchange and reduced oxygenation of the blood, resulting in respiratory dysfunction.

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3.

Signs and symptoms of a pulmonary embolism depend on ________________.

A.

Size and location of clot.
B.

Amount of blood that can flow around clot.
C.

Patient's pulmonary health prior to the pulmonary embolism.

Correct Answer
A. Size and location of clot.

Explanation
The signs and symptoms of a pulmonary embolism vary depending on the size and location of the clot. A larger clot that obstructs a major blood vessel in the lungs can cause severe symptoms such as sudden shortness of breath, chest pain, and coughing up blood. On the other hand, a smaller clot or a clot in a less critical area may result in milder symptoms or even be asymptomatic. Therefore, the size and location of the clot play a crucial role in determining the signs and symptoms experienced by the individual.

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4.

The most common site of origination of pulmonary embolisms (PE) is/are __________________.

A.

Deep veins of lower extremeties (LE).
B.

Pelvis
C.

Right atrium
D.

Both a and b
E.

Both a and c
F.

Both b and c
G.

All of the above

Correct Answer
G. All of the above

Explanation
Pulmonary embolisms (PE) can originate from multiple sites, including the deep veins of the lower extremities (LE), the pelvis, and the right atrium. Therefore, the correct answer is "all of the above," as PE can originate from any of these locations.

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5.

CHECK ALL THAT APPLY: Risk factors for PE include which of the following?

A.

Advanced age
B.

Young age
C.

Contraceptive use
D.

Trauma to blood vessels
E.

Underweight
F.

Obesity
G.

Surgery
H.

Hypercoagulability
I.

Recent respiratory infection
J.

Chronic respiratory disease
K.

Immobility

Correct Answer(s)
A. Advanced age
C. Contraceptive use
D. Trauma to blood vessels
F. Obesity
G. Surgery
H. Hypercoagulability
K. Immobility

Explanation
Risk factors for PE include advanced age, contraceptive use, trauma to blood vessels, obesity, surgery, hypercoagulability, and immobility. These factors increase the likelihood of developing a blood clot in the lungs. Young age, underweight, recent respiratory infection, and chronic respiratory disease are not typically considered risk factors for PE.

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6.

CHECK ALL THAT APPLY: Which of the following are possible signs and symptoms of a PE?

A.

Restlessness
B.

Cyanosis
C.

Tachypnia
D.

Tachycardia
E.

Decreased BP
F.

Decreased SpO2
G.

Chest pain (dull, achy)
H.

Chest pain (sharp, stabbing)
I.

Chest pain (hollow, pressure)
J.

Hemoptysis
K.

JVD
L.

Mental status changes
M.

Dyspnea
N.

Decreased heart rate
O.

Increased heart rate
P.

Decreased temp
Q.

Increased temp
R.

Sense of impending doom
S.

Anxiety

Correct Answer(s)
A. Restlessness
B. Cyanosis
C. Tachypnia
D. Tachycardia
E. Decreased BP
F. Decreased SpO2
H. Chest pain (sharp, stabbing)
J. Hemoptysis
K. JVD
L. Mental status changes
M. Dyspnea
O. Increased heart rate
Q. Increased temp
R. Sense of impending doom
S. Anxiety

Explanation
Possible signs and symptoms of a PE include restlessness, cyanosis, tachypnea, tachycardia, decreased BP, decreased SpO2, chest pain (sharp, stabbing), hemoptysis, JVD, mental status changes, dyspnea, increased heart rate, increased temp, sense of impending doom, and anxiety. These symptoms can indicate a pulmonary embolism, a blockage in the arteries of the lungs, which can be life-threatening.

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7.

CHECK ALL THAT APPLY: Which of the following are appropriate interventions for a PE?

A.

O2 (ventilator if necessary)
B.

Heparin drip
C.

Cough and Deep Breath
D.

Vena Cava filter
E.

Massage
F.

Elevate LE
G.

Embolectomy
H.

Monitor SpO2
I.

Position in High Fowler's
J.

Monitor PT and PTT
K.

Monitor INR and D-dimer
L.

Monitor for bleeding and injuries (if on a thromboembolytic)

Correct Answer(s)
A. O2 (ventilator if necessary)
B. Heparin drip
D. Vena Cava filter
G. Embolectomy
H. Monitor SpO2
I. Position in High Fowler's
J. Monitor PT and PTT
K. Monitor INR and D-dimer
L. Monitor for bleeding and injuries (if on a thromboembolytic)

Explanation
Appropriate interventions for a PE include administering O2 (ventilator if necessary) to improve oxygenation, initiating a Heparin drip to prevent further clot formation, placing a Vena Cava filter to prevent migration of clots to the lungs, performing an Embolectomy to remove the clot, monitoring SpO2 levels to assess oxygen saturation, positioning the patient in High Fowler's position to improve lung expansion, monitoring PT and PTT levels to assess coagulation status, monitoring INR and D-dimer levels to evaluate clotting factors and fibrin degradation, and monitoring for bleeding and injuries if the patient is on a thromboembolytic medication. Massage and elevating LE are not appropriate interventions for a PE.

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8.

Hemoptysis is ________________________.

A.

Coughing up blood
B.

Bloody sinus secretions
C.

Vomiting blood

Correct Answer
A. Coughing up blood

Explanation
Hemoptysis refers to the act of coughing up blood. It occurs when blood from the respiratory tract, such as the lungs or airways, is expelled through coughing. This can be caused by various underlying conditions, including lung infections, bronchitis, tuberculosis, or even lung cancer. Coughing up blood should always be taken seriously and requires medical attention to determine the cause and provide appropriate treatment.

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