Introduction: Pulmonary embolism is a disorder caused by the sudden obstruction in the pulmonary artery with consequent obstruction of blood flow to the lung tissue. A thrombus that most often comes from the deep veins of the legs or pelvis is the most common cause. Shortness of breath is the most common symptom of pulmonary embolism. Patients may experience panic attacks due to tachypnea, anxiety, and restlessness, and sharp pain may be present in the chest, especially if the person is breathing deeply (pleuritic pain). Headaches, fainting, and cramps may occur due to the reduced ability of the heart to deliver a sufficient amount of oxygenated blood to the brain and other organs. Also, irregular heart rhythm and cyanosis can occur. Symptoms of pulmonary embolism occur abruptly. Fever, pleuritic chest pain, cough, and bloody sputum are symptoms of a lung infarction. A pulmonary embolism is seen as a filling defect at pulmonary angiography. Treatment of pulmonary embolism is performed with anticoagulant and/or fibrinolytic therapy, oxygen, analgesics, and sedatives. Mortality depends on the size of the embolus, the size and number of obstructed pulmonary arteries, and the patient’s previous cardiopulmonary status. (1) The aim of this paper is to present the treatment and acute care of a patient with massive pulmonary embolism and the interventions of a nurse.
Case report: 52-year-old patient was admitted to the Department of Intensive Cardiac Care due to a massive pulmonary embolism confirmed by CT angiography. Before a hospitalization, on several occasions at home, she felt dyspnea accompanied by chest discomfort, which first stopped spontaneously, and later after taking therapy for asthma, which she has been suffering from for 2-3 years. Due to the worsening of dyspnea, the patient decided to call an ambulance, which measured 70% oxygen saturation, 105 bpm heart rate, and systolic pressure 200 mmHg. The patient’s family history was positive for cardiovascular disease. Upon admission, the patient was still mildly dyspneic, with 91% oxygen saturation on oxygen therapy with 2L on a nasal catheter, blood pressure 160/110, 107 bpm heart rate, and required an elevated position. Due to the high-risk acute pulmonary embolism, the patient received fibrinolytic therapy with alteplase, which went without complications, and a complete treatment was performed. During hospitalization, the patient was continuously monitored, vital parameters were measured and recorded, laboratory findings were monitored, therapy was applied according to the doctor’s prescription, and health care was provided.