CVP Installation

1. Consult a physician for drug delivery of low-dose heparin for high-risk clients until he ambulation. (Low-dose heparin therapy will result in blood viscosity and thrombosis decreased holding capacity and allows the risk of embolism)

2. Keep track of the signs and symptoms of pulmonary embolism

a. Acute chest pain and clear
b. Dyspnea, fatigue, cyanosis
c. Decrease in oxygen saturation
d. Tachycardia
e. Jugular venous distension
f. Hypotension
g. Acute dilatation of the right venrikel without parenchymal disease (on chest X-ray)
h. Mental disorder
i. Cardiac dysrhythmia
(Pulmonary artery occlusion disrupt blood flow to the lungs resulting in hypoxia distal)

3. If these manifestations occur, perform the protocol on the shock:

a. Keep the IV catheter (for the administration of fluids and drugs)
b. Give the gift of liquids treatment in accordance with the protocol
c. Replace indwelling catheter (Foley) (to monitor the volume of circulation through urine output)
d. Perform EKG monitoring and invasive hemodynamic monitoring (to detect dysrhythmias and treatment guidelines)
e. Give a vasopressor to increase peripheral resistance and increase blood pressure
f. Give sodium bicarbonate as indicated (to correct metabolic acidosis)
g. Give the drugs digitalis, diuretics IV and arrhythmia agents as indicated
h. Give a low dose of morphine IV (lower anxiety and reduce the need for metabolism)
i. Prepare client for procedure angiography and / or perfusion lung Scanning (to confirm the diagnosis and detect the extent of atelectasis)
(Due to massive pulmonary embolism deaths occur within the first 2 hours after awitan, immediate intervention is very important)

4. Give oxygen therapy via nasal catheter and oxygen saturation monitor. (With this action will increase the circulation of oxygen by rapidly)

5. Monitor electrolyte values, GDA, BUN, DL (this laboratory to help determine the status of perfusion and volume)

6. Do thrombolytic treatment, eg urokinase, streptokinase in accordance with the program physician (thrombolysis can cause embolic lysis and increased pulmonary capillary perfusion)

7. After treatment with intravenous thrombolysis, did the provision of treatment with heparin. (IV continuous or intermittent). (Heparin can inhibit or slow down the process of thrombus formation and helps prevent the formation and recurrence of clots.