Acute Pulmonary Thromboembolism with Systemic Lupus Erythematous
Shalini1, Baranika2
1Non Critical Ward Senior Staff Nurse, Kauvery Heartcity, Trichy, India
2Non Critical Ward Junior Staff Nurse, Kauvery Heartcity, Trichy, India
*Correspondence: nursing.heartcity@kauveryhospital.com
Case Presentation
Present History
Patient had complaints of dyspnea since two days; also giddiness. Initially went to a hospital, assessed as pulmonary thromboembolism and referred to Heart City
Past Medical History
The Patient was known to have systemic lupus erythematosus (2011), lupus nephritis and was on treatment with :
Tab.Cellcept 1gm BD
Tab.WYsolone 10mg OD
Tab.Shellcal 500mg OD
Tab.Folvite 5mg OD
Past Surgical History
Past surgical history of umbilical hernioplasty (2019)
Menstrual History
The patient had regular menstrual cycle 2 to 3 days with severe abdomen pain and body pain presented.
Acute Pulmonary Embolism
An acute pulmonary embolism or embolus is a blockage of a pulmonary artery most often. The condition result from a blood clot that forms in the lungs or another part of the body (Deep Vein Thrombosis) DVT and travels to the lungs.
Usual Causes
Book Picture |
Patient Picture |
Inmobilization
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Usual signs and Symptoms
May have |
Our patient had |
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Investigations done
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ECG
![Acute1](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute1.png)
ECHO Report
RA & RV dilated; Moderate PAH
USG abdomen Report:
![Acute2](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute2.png)
Lupus Anticoagulant report:
![Acute3](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute3.png)
Anti Phospholipid antibody IgM Report:
![Acute4](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute4.png)
Anti Phospholipid antibody IgG Report
![Acute5](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute5.png)
Anti Nuclear Antibody Report
![Acute6](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute6.png)
CA 125 Report
![Acute7](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute7.png)
Venous Doppler Report Right & Left Leg
Right Leg:
![Acute8](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute8.png)
Left Leg:
![Acute9](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute9.png)
CT pulmonary Angio Report
![Acute10](https://www.kauveryhospital.com/images/nightingale/v2i2/Acute10.png)
Management
The main treatment for a pulmonary thrombo embolism is an anticoagulant (blood thinner) depending on the severity of the clot and its effect on other organs such as the heart . Patient may also undergo thrombolytic therapy surgery or interventional preoceduce to improve blood flow in thepulmonary arteries.
The patient rece ived
Inj.Alteplase lysed 100mg over two hours.
Inj.Clexane 60mg BD
Tab. Acitrom 1mg or if INR value in correction dose given to the patient.
Regular blood tests evaluation was done and continued the anticoagulant medicine, the most important for Tab. Acitrom in (if INR value in atternative dose given to the patient). Monitored the patient for any bleeding present and preventede any injuries. The managment of diet was very clearly explained to patient and relatives.
Maintained and monitored the vital signs.
Nursing Management
- Monitored vital signs, maintained provided the comfortable position, and provided the safety measures.
- To administered the medication correct time and correct dose given to the patient
- To maintained the intake and output chart and weight monitoring daily.
- To monitored the patient any allergic reaction in medicine side effects.
- Diet pattern explained to patient and patient relative (No vitamin K diet).
- Semi fowler position with pillow supported to prevent the breathing difficulty.
- Health remote the patient and regular monitored the blood tests.
- Explained to patient to avoid the heavy work and stain.
- To provide the psychological support
- To educate the regular follow-up care and continue the take rest.
- To maintain personal hygiene, avoid to air pollution.
- Advised to take regular follow up care.
Outcome
We received the good outcome because of our effective treatment and also received the great blessings from the patient with his smiling face as the patient happily returns back to his home.
![Acutedr1](https://www.kauveryhospital.com/images/nightingale/v2i2/Acutedr1.png)
Ms. Shalini
Senior Staff Nurse
![Acutedr2](https://www.kauveryhospital.com/images/nightingale/v2i2/Acutedr2.jpg)
Ms. Baranika
Junior Staff Nurse