Nursing Dx for bilat PEs

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I had a patient this week with bilat PEs. My paperwork for school is due tomorrow. None of the diagnosis that I have searched work for this particular case. He has been on Heparin for several days and his lab values are normal/therapeutic. I am having a hard time coming up with a #1 priority dx. Any help will be appreciated!

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Specializes in Critical Care.

Think this through: What are problems that can occur when you have clots in your pulmonary vasculature?

Impaired Gas exchange related to altered blood flow comes to mind as my #1 priority.

Impaired tissue perfusion, decreased cardiac output, fatigue, activity intolerance, risk for injury-- they aren't far behind.

Remember that heparin only prevents worsening of clot formation and does nothing to dissolve the clots, so these may all be issues. Of course, if defining characteristics are absent, consider such things as risks instead of actuals.

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I suppose I will have to go with a risk. Our instructors usually do not like for us to use those as priority. From my assessments, there just aren't any other problems at this time. Thanks for your help.

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Specializes in Critical Care.
I suppose I will have to go with a risk. Our instructors usually do not like for us to use those as priority. From my assessments, there just aren't any other problems at this time. Thanks for your help.

The patient doesn't have any fatigue or activity intolerance with bilateral PEs?

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Nope.. nothing... he was walking up and down the halls all day.. no problems at all. He was admitted on the 11th and I took care of him the 14th. He had been using O2 only while sleeping until the 13th. He was basically a miracle man. He is very lucky to still be with us ha.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

Miracle man? Why do the doctors think he got these blood clots? Miracle men don't develop blood clots unless there is a reason.

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Don't attack..I just meant he probably should have been dead and he isn't. I did use risk for injury. Thanks for all the help.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

I am not attacking. I am trying to stop you from minimizing this patient's situation. I am trying to get you to think. This man is in the hospital for a reason and you are just not seeing it. I'll bow out if you don't want my help.

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