Nursing care of patients with pulmonary embolism

Plućna embolija je bolest koja nastaje prilikom nakupljanja zgrušane krvi u arterijama, a posljedica toga je opstrukcija dotoka krvi u plućno tkivo. Plućna embolija značajan je zdravstveni problem i može se pojaviti kao hitno kardiovaskularno stanje. Uzrok plućne embolije je zaglavljen krvni ugrušak u arteriji u plućima. Krvni ugrušci najčešće nastaju u donjim ekstremitetima, ali ne isključuje se mogućnost njihovog nastajanja i u drugim dijelovima tijela. Ugrušci se proširuju u oba plućna krila, ali praksa nalaže da je češće da se krvni ugrušak proširi u desnom plućnom krilu nego u lijevom plućnom krilu. Plućna embolija može biti opasna po život, što dokazuje podatak da je na 100.000 ljudi oboljelih od ove bolesti otprilike između 60-112, a stopa smrtnosti u akutnoj fazi bolesti je između 7% do 11% slučajeva. Brza reakcija, tretmani te mjere za suzbijanje nastanka krvnih ugrušaka u nogama i drugim dijelovima tijela mogu uvelike pomoći u smanjenju rizika od smrti. Dijagnoza plućne embolije teško se postavlja te vrlo često može ostati neprepoznata zbog nespecifične kliničke slike. Simptomi plućne embolije mogu varirati, a sve ovisi o tome koliko su ugrušci zahvatili pluća. Simptomi koji u najvećem broju slučajeva ukazuju na plućnu emboliju su kratkoća daha, bol u prsima, kašalj koji ponekad proizvodi krvavi ili prošarani ispljuvak, bol i/ili oteklina u nogama, pretjerano znojenje, nepravilan rad srca te vrtoglavica. Plućna embolija može se liječiti na dva načina, lijekovima, odnosno trombolitičkim terapijama i kirurškim zahvatima. Lijekovi poput antikoagulansa mogu spriječiti formiranje krvnih ugrušaka, no taj način terapije lijekovima traje duže. Lijekovi poput trombolitika mogu otopiti krvni ugrušak brzo, no oni mogu izazvati krvarenje te dovesti oboljelog u stanje opasno po život. Prema tome potrebno je odrediti da li oboljeli spada u skupinu osoba koje su operirane u prethodnih deset dana, trudnice, osobe koje su pretrpjele moždani udar te osobe sklone jakom krvarenju, time te osobe nisu pogodne za takav način liječenja. Kirurški postupak primjenjuje se samo kod oboljelih s uznapredovalom plućnom embolijom kojima plućna embolektomija, odnosno uklanjanje embolusa iz plućne arterije može spasiti život. Ukoliko se ugrušci ponovno pojavljuju, tada se koristi filter koji sprječava prenošenje ugrušaka u plućnu arteriju. Najvažniji dio terapije oboljelih je edukacija, što podrazumijeva informiranje oboljelog o bolesti te načinu uzimanja lijekova, čime se dolazi do oporavka i posljedično boljeg stanja organizma. Važno je uspostaviti dobar odnos između oboljelog te liječnika i medicinske sestre.Pulmonary embolism is a disease that occurs when clotted blood accumulates in the arteries, resulting in the obstruction of blood flow in the lung. Pulmonary embolism is a significant health problem and may appear as urgent cardiovascular condition. The cause of pulmonary embolism is jammed a blood clot in an artery in the lungs. Blood clots usually occur in the lower extremities, but does not exclude the possibility of their formation in other parts of the body. Clots are expanded in both lungs, or practice dictates that the more often it is a blood clot spread in the right lung than it is in the left lung. Pulmonary embolism can be life-threatening, according to the fact that at the number of 100,000 people, 60 to 112 people will suffer from this disease, and the mortality rate in the acute phase of the disease is between 7% to 11% of cases. Quick reaction, treatments and measures to combat the formation of blood clots in the legs and other parts of the bodies can greatly help reduce the risk of death. The diagnosis of pulmonary embolism can be elusive and very often unrecognized because of nonspecific clinical picture. Symptoms of pulmonary embolism may vary, but all depends on how the affected lung clots are. Symptoms that indicate pulmonary embolism are shortness of breath, chest pain, cough that sometimes produces blood or sputum streaked with pain and / or swelling in the legs, excessive sweating, irregular heartbeat and dizziness. Pulmonary embolism can be treated in two ways, by medicaments, or with thrombolytic therapies and surgical procedures. Medications such as anticoagulants may prevent the formation of blood clots, but this way drug therapy last longer. Drugs such as thrombolytics can dissolve the blood clot quickly, but they can cause bleeding and lead patient in life-threatening condition. Therefore, it is necessary to determine whether patient belongs to the group of people that are operated in the previous ten days, pregnant women, persons who have suffered a stroke, and people tend heavy bleeding, those group of patients are not suitable for that type of treatment. Surgical procedure applies only in patients with advanced pulmonary embolism where pulmonary embolectomy and removal of emboli from the pulmonary artery can save your life. If the clots occur again, then uses the filter which prevents the transmission of blood clots in the pulmonary artery. The most important part of therapy patients is education, which includes informing the patient about the disease and how to take your medication, which leads to the recovery and, consequently, better body condition. It is important to establish a good relationship between the patient and the doctor and nurses