This is probably a reeeeealy stupid question, but I am working on this care plan and struggling with my STO and LTO. They told us this would be difficult because of our lack of experience. Anyway, what would be a reasonable timeframe for resolution of impaired gas exchange r/t pulmonary embolism? Or is there such a thing--maybe I am totally on the wrong track here...it wouldn't be the first time! :roll :roll
Thanks for any help or guidance--I am feeling really inadequate here!
Carol (RN 2B Dec 2003)
Sep 24, '02
The client will experience adequate O2/CO2 exchange as evidenced by:
usual mental status
unlabored respirations at 12 - 20/minute
oximetry results within normal range
blood gases within normal range.
Assess for and report signs and symptoms of impaired gas exchange:
significant decrease in oximetry results
decreased PaO2 and/or increased PaCO2
central cyanosis (a late sign).
Implement measures to improve gas exchange:
maintain client on bed rest to reduce oxygen demands during acute respiratory distress; increase activity gradually as allowed and tolerated
maintain oxygen therapy as ordered
perform actions to improve breathing pattern
discourage smoking (the carbon monoxide in smoke decreases oxygen availability and the nicotine can cause vasoconstriction and further reduce pulmonary blood flow)
perform actions to improve pulmonary blood flow:
administer anticoagulants (e.g. continuous intravenous heparin, warfarin) as ordered
Consult appropriate health care provider (e.g. respiratory therapist, physician) if signs and symptoms of impaired gas exchange persist or worsen.
Sep 24, '02
Thank you so much Rusty! I was on the right track I think--from what you posted at least! My instructor may think otherwise :chuckle