A client has a pulmonary embolism and is started on oxygen. The ...

[ETearle]

A client has a pulmonary embolism and is started on oxygen. The student nurse asks why the client's oxygen saturation has not significantly improved. What response by the nurse is best?
 
  a. Breathing so rapidly interferes with oxygenation.
  b. Maybe the client has respiratory distress syndrome.
  c. The blood clot interferes with perfusion in the lungs.
  d. The client needs immediate intubation and mechanical ventilation.

Question 2

A client is admitted with a pulmonary embolism (PE). The client is young, healthy, and active and has no known risk factors for PE. What action by the nurse is most appropriate?
 
  a. Encourage the client to walk 5 minutes each hour.
  b. Refer the client to smoking cessation classes.
  c. Teach the client about factor V Leiden testing.
  d. Tell the client that sometimes no cause for disease is found.

[JaynaD87]

Answer to Question 1

ANS: C
A large blood clot in the lungs will significantly impair gas exchange and oxygenation. Unless the clot is dissolved, this process will continue unabated. Hyperventilation can interfere with oxygenation by shallow breathing, but there is no evidence that the client is hyperventilating, and this is also not the most precise physiologic answer. Respiratory distress syndrome can occur, but this is not as likely. The client may need to be mechanically ventilated, but without concrete data on FiO2 and SaO2, the nurse cannot make that judgment.

Answer to Question 2

ANS: C
Factor V Leiden is an inherited thrombophilia that can lead to abnormal clotting events, including PE. A client with no known risk factors for this disorder should be referred for testing. Encouraging the client to walk is healthy, but is not related to the development of a PE in this case, nor is smoking. Although there are cases of disease where no cause is ever found, this assumption is premature.

[ETearle]

Thanks for the timely response, appreciate it

[yeungji]

TYSM