Embolic Emma — Pulmonary Embolism
Sudden dyspnea — High-Fowler's + oxygen first
Emma sat still on a long flight while a clot packed its bags in her calf. Somewhere over the ocean it boarded the vena cava, flew to her lung and shut down the runway.
Emma's dyspnea hits out of nowhere with pleuritic chest pain, tachycardia and anxiety. First nursing action is High-Fowler's plus oxygen, then notify the provider and prepare for anticoagulation. Watch for hypoxia that doesn't improve and sudden hypotension.
Read Embolic Emma's full story →The story arc
The setup
A twelve-hour flight, oral contraceptives and a swollen left calf she blamed on her shoes.
The turn
Two days later she stands up and cannot breathe. Sharp pain stabs with each inhale.
The crisis
SpO₂ 86% on 4 L, heart rate 128, and she says she feels like something terrible is about to happen.
The save
High-Fowler's and oxygen first, provider notified, CT angiogram confirms, heparin infusion started with aPTT monitoring.
NCLEX study section — Pulmonary Embolism
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Respiratory
Take this chapter into practice questions on the same topic.