Help asap pulmonary embolism

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the 38-year-old female client with pulmonary embolism who is now being mechanically ventilated suddenly become agitated and starts "bucking" the ventilator. you notice that her blood pressure is starting to fall, she is using accessory muscles, and she has no breath sounds on the right side of her chest.

1. what is the most likely cause of these symptoms.

2. what should you do first?

two days later, this client is switched from assist-control (ac) ventilation of 12 to synchronized intermittent mandatory ventilation (simv) of 10, to start weaning. you notice that she is grimacing and holding her breath.

3. what is the most likely cause of her pain? the pain is caused by decrease in o2 and the patients inability to tolerated weaning. specifically

4. what is the best way of relieving her pain?

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Specializes in Medical and general practice now LTC.

As much as we like to help students it would help us to help you if you give some input into what you have already researched up to now and some of your ideas into the questions

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As much as we like to help students it would help us to help you if you give some input into what you have already researched up to now and some of your ideas into the questions

Agreed; we are willing to help, but not to do your homework for you. :)

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I have extensively researched this subject and what I found was that the pt might be from insertion of trach tube. My first response would be to call a code for respiratory.

Second it states that there may be kink in the tubing, pt might be biting the tubing or that the pressure volumes are causing a pneumothorax. ... no breathe sounds on rt side. My guess would be a tension pneumothorax.

I'm confused.

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the 38-year-old female client with pulmonary embolism who is now being mechanically ventilated suddenly become agitated and starts "bucking" the ventilator. you notice that her blood pressure is starting to fall, she is using accessory muscles, and she has no breath sounds on the right side of her chest.

1. what is the most likely cause of these symptoms ? barotrauma damage to the lung from rapid or excessive pressure changes, as may occur when a patient is on a ventilator and is subjected to high airway pressure. resulting in a pnuemothorax causing the lack of breath sounds on the rt side of chest. barotrauma causes breath holding and this may be the cause of the bucking of the ventilator. breathing is not synchronized.

2. what should you do first? treatment is to maintain cardiovascular and respiratory functions. oxygen therapy as needed and anti coagulants drugs along with clot dissolv/ing drugs, and vasopressors for the drop in blood pressure.

two days later, this client is switched from assist-control (ac) ventilation of 12 to synchronized intermittent mandatory ventilation (simv) of 10, to start weaning. you notice that she is grimacing and holding her breath.

3. what is the most likely cause of her pain? the pain is from the pneumothorax and also by weakening of respiratory muscles, irritation in the chest area.

4. what is the best way of relieving her pain? adminstration of analgesics and anti anxiety drugs. turning and repositioning the client will promote comfort, prevent skin breakdown and prevent pneumonia and atelectisis

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you stated you needed my input first so if possible can someone please answer my post on the pulmonary embolism case study? Really need the input!!!!

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Specializes in Medical and general practice now LTC.

Merged threads for continuity

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