Primary Nursing Diagnosis

Impaired gas exchange related to impaired pulmonary blood flow and alveolar collapse

OUTCOMES. Respiratory status: Gas exchange; Respiratory status: Ventilation; Symptom control behavior; Treatment behavior: Illness or injury; Comfort level

INTERVENTIONS. Airway management; Anxiety reduction; Oxygen therapy; Airway suctioning; Airway insertion and stabilization; Cough enhancement; Mechanical ventilation; Positioning; Respiratory monitoring


Massive PE is a medical emergency. Make sure that the patient's airway, breathing, and circulation are maintained. Administer oxygen immediately to support gas exchange and prepare for the possibility of intubation and mechanical ventilation. Obtain intravenous (IV) access for administration of fluids and pharmacologic agents. Before administration of thrombolytic agents, draw a coagluation profile and complete blood count to obtain a baseline.

Although it is rare, severe cases of PE that are unresponsive to anticoagulant or thrombolytic therapy may require surgery. The least invasive technique is the insertion of a transvenous catheter into the pulmonary vasculature. If the procedure is unsuccessful, however, a thoraco-tomy may be required to remove the obstructing embolism. Patients prone to PE seeded from deep vein thrombi may have a prosthetic umbrella inserted into the inferior vena cava to trap the emboli.

792 Pulmonary Embolism

Pharmacologic Highlights

Medication or Drug Class





Varies with drug and patient weight;

Sodium heparin;

Standard treatment is to

Free Yourself from Panic Attacks

Free Yourself from Panic Attacks

With all the stresses and strains of modern living, panic attacks are become a common problem for many people. Panic attacks occur when the pressure we are living under starts to creep up and overwhelm us. Often it's a result of running on the treadmill of life and forgetting to watch the signs and symptoms of the effects of excessive stress on our bodies. Thankfully panic attacks are very treatable. Often it is just a matter of learning to recognize the symptoms and learn simple but effective techniques that help you release yourself from the crippling effects a panic attack can bring.

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