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Perfusion Exam 4
Pulmonary Embolism Causes
Causes
FAT BAT Mnemonic
Fat
Air
Deep Vein Thrombosis (DVT)
Bacteria
Amniotic Fluid
Tumor
Risk Factors
Hypercoagulable
Central Venous Lines
Immobilized
1 min
Pulmonary Embolism Assessment
Assessment
Shortness of Breath (SOB)
Pleuritic Chest Pain
Tachypnea
Hemoptysis
Hypoxemia
Considerations
Sudden Death
52 secs
A-a Gradient
Partial pressure of alveolar oxygen (PAO2)
Partial Pressure of Arterial O2 (PaO2)
Normal 10 to 15 mmHg
Hypoxemia with an Abnormal A-a Gradient
Diffusion problem
Shunting (Low V/Q)
Dead space (high V/Q)
1 min
Heparin (Unfractionated)
Mechanism of Action
Suppresses Coagulation
Indications
Deep Vein Thrombosis (DVT)
Pulmonary Embolism
Side Effects
Hemorrhage
Heparin-Induced Thrombocytopenia (HIT)
Considerations
Monitor aPTT
Preferred (Safe) During Pregnancy
Antidote
Protamine Sulfate
2 mins
Enoxaparin (Lovenox)
Mechanism of Action
Inhibits Clotting Factors
Factor Xa
Indications
Clot Formation Prevention
Side Effects
Heparin Induced Thrombocytopenia (HIT)
Bleeding
Considerations
Medication Education
Subcutaneous Injection
2 Inches from Umbilicus or Incisions
Antidote
Protamine Sulfate
2 mins
PT/PTT Lab Values
Prothrombin Time (PT)
10-14 seconds
Activated Partial Thromboplastin Time (PTT or aPTT)
Decreased or Absent Breath Sounds on Affected Side
Chest Pain
Tracheal Deviation
Vital Sign Changes
Crepitus
Considerations
High Fowler's Position With Oxygen
Prepare For Chest Tube Placement
Educate High Risk Patients
2 mins
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
1 min
Beta-2 Agonists
Short-term Treatment
Terbutaline
Asthma
Tocolysis
Albuterol
Asthma
Long-term Treatment
Salmeterol
Asthma
Chronic Obstructive Pulmonary Disease (COPD)
3 mins
Albuterol (Proventil)
Mechanism
Short-Acting Beta-2 Agonist
Indications
Bronchospasm
Asthma
Side Effects
Angina
Tachycardia
Tremor
1 min
Cromolyn (Mast Cell Stabilizers)
Mechanism
Mast Cell Stabilizer
Indications
Asthma Prophylaxis
Bronchial Inflammation
Allergic Rhinitis
Side Effects
Cough
Bronchospasm
Consideration
Fixed Schedule Administration
2 mins
Theophylline (Theo-24)
Mechanism
Bronchial Smooth Muscle Relaxation
Indications
Asthma
Side Effects
Insomnia
Restlessness
Arrhythmias
Seizures
Considerations
Narrow Therapeutic Range
Monitor Plasma Levels
1 min
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