Question

CASE STUDY 15.3 Patty has just undersone abdominal hysterecool and, due to complications, has been bed-boun a week. She develops an abrupt onset of chest nt and shortness of breath. She is taken to the en gency department and diagnosed with p b embolism, which is a blockage in d vessels in the lungs, most likely from a hich cii that traveled from her legs. Think aboudmost rela ical model discussed in this chapter 1s to this process. From your reading regarding ventilation and diffusion, lowing questions: terectomy d for in 1 a pulmona one of her blood bout which clin n this chapter is mos answer the 1. What process is most likely ocu woman's body? occurring in

Answer 1

1. Pulmonary thromboembolism
2. Acute pulmonary embolism causes redistribution of blood in the lung, which impairs ventilation/perfusion matching and gas exchange and can elevate pulmonary arterial pressure (PAP) by increasing pulmonary vascular resistance (PVR).
3. Clinical Manifestations that can be expected are

4. Shortness of breath

   Rapid breathing

   Chest pain: This is usually a sharp stabbing pain that may worsen when we breathe in.

   Seizures

   Syncope

       Abdominal pain

   Fever

   Productive cough

   Wheezing

   Decreasing level of consciousness

   4)

   Laboratory tests in patients with suspected pulmonary embolism are the following:

   White blood cell count

   Arterial blood gases:

   Serum troponin levels

   Brain natriuretic peptide

   D-dimer testing

   Ischemia-modified albumin level

   Imaging studies that help in the diagnosis of pulmonary embolism are the following:

   V/Q scanning, ECG and MRI

   Echocardiography

   Venography and Duplex ultrasonography

   Computed tomography angiography

   Pulmonary angiography

   Chest radiography

   5) The main treatment is called an anticoagulant. This is a drug that causes chemical changes in our blood to stop it clotting easily.

   Anticoagulant medications are warfarin (Coumadin), heparin, low-molecular weight heparin (such as Lovenox or Dalteparin) and fondaparinux (Arixtra)

   Other treatment options are

   Compression Stockings and Thrombolytic Therapy