Healthcare professionals create care plans to help manage conditions such as pulmonary embolism. Planning may help improve outcomes and prevent future occurrences of the condition.
Care plans are an important part of the care process for pulmonary embolism. These plans help nurses and other healthcare professionals know the most effective way to treat people with pulmonary embolism, including the treatment goals and guidelines to follow.
This article reviews what nursing care plans are, what may be involved in the plans, common treatments for pulmonary embolism, and more.
Nursing care plans form an important part of the nursing process. American nurse Ida Jean Orlando created the current nursing process guidelines in
The nursing process defines a systematic approach to nursing care. It involves several aspects, including:
- critical thinking
- client-centered approaches to treatment
- goal-oriented tasks
- evidence-based practice (EDP) recommendations
- nursing intuition
The nurse planning stage and development of a nursing care plan include patient-specific care based on EDP recommendations. Healthcare professionals can then use the plan to help the person achieve a positive outcome.
Plans should consider the person’s overall health, including the presence of other conditions.
Goals of a nursing plan should be:
- specific
- timely or time-oriented
- measurable or meaningful to the person
- realistic or results-oriented
- attainable or action-oriented
Once a plan is in place, nurses and other healthcare professionals can implement the plan.
The benefits of a nursing plan can include improved:
- communication
- documentation
- insurance reimbursement
- continuity of care across the healthcare settings
Some limitations in nursing care plans and documentation can occur. According to a 2018 review, standardized nursing language can help improve care and outcomes, particularly across settings.
A nursing care plan for a pulmonary embolism can vary based on the facility. It also varies between individuals due to the tailored nature of care.
Minimize risk
Minimizing risk involves reducing the chances of pulmonary embolisms and deep vein thrombosis (DVT).
A nurse can help reduce the risk of thrombosis through various strategies, such as:
- educating people on the importance of leg exercises
- encouraging movement throughout the day
- using intermittent pneumatic compression devices to promote blood flow
- monitoring and changing catheter or intravenous (IV) placement to prevent blood clot formation
- regularly monitoring vital signs, such as heart rate and blood pressure
Manage gas exchange and oxygen therapy
Oxygen therapy
Gas exchange is the process where the air in the lungs transfers to the blood to circulate throughout the body. During care in a hospital or other clinical setting, nurses can check for signs that gas exchange is occurring as it should be.
To monitor gas exchange, a nurse can check for:
- discoloration under the fingernails, mucous membranes, or skin
- changes in vital signs
- mental acuity and other signs of hypoxia
- changes in lung activity
- signs of abnormal heart rhythms or beating patterns
- the presence of lumps in the calves
Maintain airway clearance and breathing pattern
Airway clearance maintenance involves making sure nothing, including foreign objects, mucus, or other things, are blocking the airways.
Nurses also monitor a person for signs of changes in their breathing pattern.
Manage bleeding risk
Part of care for pulmonary embolisms
Nurses can help minimize the risk of bleeding events by thoroughly reviewing a person’s risk factors. They typically ask the person about preexisting conditions and the use of medications that may increase the risk of bleeding.
They also likely monitor for signs of bleeding. This can include finding signs of bleeding at the injection sites or mucous membranes.
Part of the care plan for bleeding may involve providing appropriate doses of anticoagulants, such as heparin, as prescribed and recommending changes to administration as needed.
Monitor diagnostic and laboratory procedures
While receiving care for a pulmonary embolism, several diagnostic tests and lab reports are needed. Part of a care plan involves a nurse monitoring the results of the tests and tailoring the care plan based on any changes.
Some possible benefits of careful monitoring of labs and diagnostic tests may include:
- helping determine the person’s response to treatment
- determining the effectiveness of the treatment
- recognizing signs of potential complications
Administer medication
One of the roles of nursing staff during treatment is to provide medications as prescribed for the continued treatment of pulmonary embolisms.
Some common medications a nurse may need to administer while a person is in their care
- anticoagulants
- thrombolytics to help rapidly dissolve clots
- pain medications, such as acetaminophen or opioids, for chest pain
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to help relieve pain and reduce inflammation
- prophylactic medications, which are low doses of heparin or other anticoagulants, to help prevent the formation of clots
- oxygen therapy
Provide individual education
A part of a nursing plan often includes providing education on a person’s condition. This may include information on topics such as:
- lifestyle changes and strategies to reduce the risk of blood clots in the future
- information on what was performed while under their care (called an after visit summary)
- recommendations for future treatment, such as explaining referrals for additional therapy
- review of next steps, such as when to schedule follow-ups with primary care doctors
Treatment for pulmonary embolism often involves short- and long-term care.
Short-term care corrects the pulmonary embolism and helps stabilize the person. It
- oxygen therapy or mechanical breathing device
- anticoagulation medication
- thrombotic medication
- insertion of catheters, as needed
- surgical correction, as needed
Long-term care may involve the use of prophylactic medications, such as low dose heparin. This can help prevent blood clots from forming.
Long-term care may also involve lifestyle strategies, such weight management and regular physical activity.
The following section answers some frequently asked questions about pulmonary embolism care.
What are the goals of care for pulmonary embolism?
The primary goals of care for pulmonary embolism can include:
- ensuring proper blood flow
- promoting and supporting lung function
- preventing complications or future clotting
Nursing goals may include:
- helping with a person’s safety
- providing emotional support
- optimizing gas exchange (oxygen getting into the blood)
- helping prevent complications or future clotting
What is the best management for pulmonary embolism?
Anticoagulation medication is the
What do you teach a patient with pulmonary embolism?
Pulmonary embolism education may involve helping a person better understand the condition and the steps they can take to prevent future occurrences.
Education may involve discussing taking heparin or other anticoagulants as prescribed. Prophylactic medications may help prevent future occurrences.
Another aspect of education may involve steps a person can take to change their lifestyle. This may involve losing weight, becoming more active, or changing diet patterns.
What should you not do with pulmonary embolism?
A person should not remain sedentary, either in bed or in a chair, for long periods.
Instead, a person should plan to move around as much as possible in the hospital setting or at home. They should also follow directions from a healthcare professional regarding when to take medications and other lifestyle changes.
A nursing plan for managing pulmonary embolism typically involves several aspects related to a person’s care. The goals are to help ensure a person’s safety, increase comfort, and help educate the person on steps to take to prevent complications and future occurrences.
Nursing plans may help with ensuring consistent care. They may help increase positive outcomes for most people.
After treatment for pulmonary embolism, a person should follow all healthcare professionals’ advice on taking medication, lifestyle changes, and follow-up care.