PN3 EXAM 3 REVIEW AND SOLUTIONS 2026
◉ Pulmonary embolism respiratory assessment. Answer: Dyspnea
Tachycardia
Tachypnea
Pleuritic chest pain
Dry cough
*Hemoptysis
*chest pain
*SOB
◉ Pulmonary embolism cardiac assessment. Answer: Distended
neck veins
Syncope
Cyanosis
Systemic hypotension
Abnormal heart sounds
Abnormal ECG
◉ Pulmonary embolism labs. Answer: ABG's
PaO2 (partial pressure of oxygen in arterial blood)-FiO2(fraction of
inspired oxygen) ratio falls
,Pulse oximetry
Imaging assessment
◉ Analysis: Interpreting Pulmonary Embolism. Answer: Hypoxemia
Hypotension
Potential for excessive bleeding
Anxiety
*Hypoxemia can trigger anxiety and sense of impending doom.
◉ Pulmonary Embolism
Planning and Implementation: Responding. Answer: · Oxygen
therapy (nasal cannula, mask)
· Continuous patient monitoring
· Obtain adequate venous access
· Continuous monitoring pulse ox
· Drug therapy (Anticoagulants, Fibrinolytics)
· Assess for bleeding every 2 hours
· Examine all stool, urine, drainage, vomitus for gross blood; test for
occult blood
· Measure abdominal girth every 8 hours
· Monitor lab values
· Surgical management (embolectomy, inferior vena cava filtration)
,· INTERVENTIONS-IVC (inferior vena cava filter) -Embolectomy -
Heparin drug therapy
◉ VAP interventions. Answer: · Elevate head of bed at least 30
degrees
· Suctioning preventing aspiration
· Oral care
· Hand hygiene
· Pulmonary hygiene, including chest physiotherapy, postural
drainage
· Turning the patient and positioning.
◉ Premature Ventricular Contraction or PVC. Answer: If it arises
from the Ventricular area, it will be a QRS which is wide and bizarre
shaped
Sinus rhythm with PVCs has an underlying regular sinus rhythm
with ventricular depolarization that sometimes precede atrial
depolarization
◉ When are PVCs a Problem?. Answer: - Increase from the patient's
normal amount
- Multiple PVCs in a row
- PVC falls on the T wave of previous beat
, - Multifocal (they arise from different cells, therefore they are
different shapes)
A wide bizarre QRS
◉ Premature Ventricular Complexes. Answer: • Increased irritability
ventricle; early complexes followed by a pause
• Interventions: eliminate the cause, ***Amiodarone, Lidocaine,
electrolyte replacement
◉ PVC can cause. Answer: Hypokalemia, meds, hypoxemia, MI,
infection, hypovolemia, stimulants
◉ PVC. Answer: Clinical manifestations: asymptomatic vs
palpitations and CP; can lead to VT, cardiomyopathy, heart failure
◉ Bigeminy. Answer: Premature ventricular contraction (PVC) every
other heart beat
◉ Trigeminy. Answer: PVC every third beat
◉ Quadrigeminy. Answer: PVC every 4th beat
◉ Pulmonary embolism respiratory assessment. Answer: Dyspnea
Tachycardia
Tachypnea
Pleuritic chest pain
Dry cough
*Hemoptysis
*chest pain
*SOB
◉ Pulmonary embolism cardiac assessment. Answer: Distended
neck veins
Syncope
Cyanosis
Systemic hypotension
Abnormal heart sounds
Abnormal ECG
◉ Pulmonary embolism labs. Answer: ABG's
PaO2 (partial pressure of oxygen in arterial blood)-FiO2(fraction of
inspired oxygen) ratio falls
,Pulse oximetry
Imaging assessment
◉ Analysis: Interpreting Pulmonary Embolism. Answer: Hypoxemia
Hypotension
Potential for excessive bleeding
Anxiety
*Hypoxemia can trigger anxiety and sense of impending doom.
◉ Pulmonary Embolism
Planning and Implementation: Responding. Answer: · Oxygen
therapy (nasal cannula, mask)
· Continuous patient monitoring
· Obtain adequate venous access
· Continuous monitoring pulse ox
· Drug therapy (Anticoagulants, Fibrinolytics)
· Assess for bleeding every 2 hours
· Examine all stool, urine, drainage, vomitus for gross blood; test for
occult blood
· Measure abdominal girth every 8 hours
· Monitor lab values
· Surgical management (embolectomy, inferior vena cava filtration)
,· INTERVENTIONS-IVC (inferior vena cava filter) -Embolectomy -
Heparin drug therapy
◉ VAP interventions. Answer: · Elevate head of bed at least 30
degrees
· Suctioning preventing aspiration
· Oral care
· Hand hygiene
· Pulmonary hygiene, including chest physiotherapy, postural
drainage
· Turning the patient and positioning.
◉ Premature Ventricular Contraction or PVC. Answer: If it arises
from the Ventricular area, it will be a QRS which is wide and bizarre
shaped
Sinus rhythm with PVCs has an underlying regular sinus rhythm
with ventricular depolarization that sometimes precede atrial
depolarization
◉ When are PVCs a Problem?. Answer: - Increase from the patient's
normal amount
- Multiple PVCs in a row
- PVC falls on the T wave of previous beat
, - Multifocal (they arise from different cells, therefore they are
different shapes)
A wide bizarre QRS
◉ Premature Ventricular Complexes. Answer: • Increased irritability
ventricle; early complexes followed by a pause
• Interventions: eliminate the cause, ***Amiodarone, Lidocaine,
electrolyte replacement
◉ PVC can cause. Answer: Hypokalemia, meds, hypoxemia, MI,
infection, hypovolemia, stimulants
◉ PVC. Answer: Clinical manifestations: asymptomatic vs
palpitations and CP; can lead to VT, cardiomyopathy, heart failure
◉ Bigeminy. Answer: Premature ventricular contraction (PVC) every
other heart beat
◉ Trigeminy. Answer: PVC every third beat
◉ Quadrigeminy. Answer: PVC every 4th beat
