5 Pulmonary Embolism Practice Questions
Review pulmonary embolism risk factors, warning signs, urgent nursing responses, diagnostic testing, treatment, and monitoring for complications.
Risk factors
Risk increases with recent major orthopedic surgery, prolonged immobility, active cancer, and pregnancy. Seasonal allergies are not a typical risk factor.
Recognizing warning signs
A possible may present with sudden shortness of breath, sharp chest pain that worsens with a deep breath, tachycardia, and low oxygen saturation. Faintness or hypotension may also occur. These findings—especially after surgery or a period of immobility—are concerning and call for urgent evaluation, but symptoms alone do not confirm the diagnosis.
Responding to acute deterioration
If a patient with suspected PE becomes acutely more short of breath, confused, or hypotensive, activate the rapid response or emergency response system immediately. Stay with the patient, assess and support airway, breathing, and circulation, apply oxygen according to emergency protocol or orders, and continuously reassess. Do not delay escalation for routine tasks, encourage walking, or wait to reassess later.
Diagnostic testing
is commonly used to image the pulmonary arteries for a clot. Depending on the patient and clinical circumstances, a ventilation-perfusion (V/Q) scan may be considered instead. A D-dimer may help guide whether further testing is needed, but it does not confirm PE by itself.
Treatment approaches
are the main treatment for most patients with PE. They help prevent a clot from growing and reduce the chance of new clots forming; they do not immediately dissolve a clot and they increase bleeding risk. Selected patients with severe or life-threatening PE may need advanced clot-removal or clot-dissolving treatment in addition to anticoagulation.
Monitoring for bleeding
New black, tarry stools and faintness during anticoagulant therapy may indicate bleeding, a serious complication. Promptly report the findings and assess for bleeding and hemodynamic changes. Medication changes should be made by the responsible clinician.
Managing high-risk PE
Persistent hypotension or signs of shock despite initial support indicate a high-risk emergency. The team may evaluate advanced PE treatment, such as or a catheter-based or surgical intervention, depending on the patient’s condition and bleeding risk. Continue close monitoring and support while urgent escalation occurs.