Which client is at greatest risk for pulmonary embolism?

Question

Quizplus · Accepted Answer

Death from pulmonary embolism is often attributed to a missed diagnosis. Early identification of risk factors (eg, venous stasis, hypercoagulability of blood, endothelial damage) can have a positive effect on client outcome. This postoperative client is at greatest risk due to the presence of the following 4 risk factors: Abdominal cesarean section surgery (endothelial damage) Engorged pelvic vessels from pregnancy (venous stasis, hypercoagulability of blood) Inactivity/immobility ≥6 hours related to positioning during surgery and the immediate postoperative period and epidural anesthesia (venous stasis) Postpartum state (hypercoagulability of blood) (Option B) In atrial fibrillation, stasis and turbulence of blood increases risk of thrombus formation. Once mobilized, emboli can get trapped in blood vessels causing ischemia. Smaller vasculature and increased blood flow in the brain increases the probability of a stroke, rather than PE. This client has 1 risk factor and is not at greatest risk for PE. (Option C) The presence of a subdural hematoma does not pose a significant risk for PE unless the client has been immobile. Many clients with subdural hematomas are asymptomatic and walking. This client is not at greatest risk for PE. (Option D) Any acute medical illness (eg, pneumonia) can predispose a client to PE from inflammation and the client's relative immobility. However, this risk is lower than the risk for PE from major surgery. Educational objective: Death from pulmonary embolism (PE) is often attributed to a missed diagnosis. Nurses must recognize any condition or situation that predisposes a client to venous stasis, hypercoagulability of blood, and endothelial damage, as these factors increase the risk for PE.

Which Client Is at greatest Risk for Pulmonary Embolism