Pulmonary Embolism Nursing Care

A pulmonary embolism is an obstruction of a pulmonary artery, most often by a thrombus that embolized from a deep vein (DVT) in the legs or pelvis. The blocked segment is ventilated but not perfused — a dead-space mismatch that causes hypoxia and, if large, acute right-heart strain. PE and DVT are two ends of one disease, venous thromboembolism (VTE).

Risk follows Virchow’s triad: venous stasis (immobility, surgery, long travel), hypercoagulability (cancer, pregnancy, estrogen, clotting disorders), and endothelial injury (trauma, surgery, central lines).

The hallmark is abrupt onset: dyspnea (most common), pleuritic chest pain, tachypnea, tachycardia, anxiety/sense of impending doom, cough, and sometimes hemoptysis. Signs of hypoxia (low SpO₂), and with a large PE, hypotension, distended neck veins, and signs of right-heart failure. Look for a source — unilateral leg swelling/pain (DVT). A normal exam does not rule it out; suspect PE in any sudden, unexplained dyspnea or hypoxia in an at-risk patient.

PE is terrifying — patients often feel they can’t breathe and may have a sense of impending doom. Stay calm and present, explain each intervention simply, and provide reassurance while you act. After stabilization, address fear of recurrence and the anxiety many feel about going home on anticoagulants, and involve family in the safety teaching.

Teach anticoagulation safety: adherence, bleeding precautions, INR monitoring (warfarin) and dietary vitamin-K consistency, drug interactions, and not stopping early. Review DVT/PE prevention — move and hydrate on long trips, leg exercises with immobility — and the warning signs to seek emergency care (sudden shortness of breath, chest pain, coughing blood, or new leg swelling/pain). Reinforce follow-up for duration-of-therapy decisions.