I. Care of patients with pulmonary embolism
General care;
1. Suitable treatment and rest environment The patient’s room should be comfortable, quiet and with fresh air.
2. Absolute bed rest to prevent venous thrombosis from dislodging and reoccurrence of pulmonary embolism.
3, pay attention to keep warm.
4.Anti-pain, if the chest pain is mild and tolerable, it can be left untreated; however, for patients with severe chest pain that affects breathing, pain relief should be given to prevent severe chest pain from affecting the patient’s breathing movement.
5.Oxygen inhalation.
6.Monitor important vital signs such as respiration, blood pressure, heart rate, heart rhythm and body temperature, etc.
7.Regularly recheck arterial blood gas and ECG.
8. Observe the reaction to medication.
Second, the common sense of care after thrombolytic therapy are
1.Psychological care After thrombolysis, patients clinically feel less symptomatic and have different degrees of desire to get out of bed, at this time, patients should understand that bed rest is still needed after thrombolysis to avoid embolism and re-embolism.
2.Effective braking After thrombolysis of acute pulmonary embolism, the lower limb deep vein thrombus is loose and easily dislodged, so it is necessary to stay in bed absolutely for 2 weeks, and not to do the movement of double lower limbs with force and massage of double lower limbs. In addition, avoid the factors of increasing abdominal pressure, such as upper respiratory tract infection, which should be treated actively to avoid increasing abdominal pressure when coughing and causing thrombus dislodgement; smokers should be advised to quit smoking; all outgoing examinations during bed rest should be transported by flat car.
3, do a good job of skin care After acute pulmonary embolism thrombolysis, bed rest for a long time, usually pay attention to the patient’s skin protection, such as the mattress softness should be moderate, keep the skin dry and the bed sheet flat. With the assistance of nursing staff, turn over once every 2~3 hours. Avoid long-term pressure and breakage of local skin.
4.Rational nutrition Diet should be light, easy to digest and rich in vitamins, and less fast-soluble and acid-prone food to ensure nutrition during the recovery period.
5.Keep bowel movement smooth In addition to eating fiber-rich food, give laxatives or glycerin enemas if necessary.
6.Discharge instruction After discharge, patients should do the following.
①Follow up regularly and take medication on time, especially anticoagulants, make sure to take them as prescribed by the doctor;
②Self-observation of bleeding phenomenon;
③Regularly review the anticoagulation index according to the doctor’s orders, and learn to read the anticoagulation index test sheets;
④Pay attention to the activities of the lower limbs in daily life, and wear elastic stockings if you have varicose veins in the lower limbs to avoid blood retention in the deep veins of the lower limbs and recurrence of thrombosis;
⑤ Seek medical attention when there is a change in the condition.