Physiological Adaptation Q 31
A nurse calls a physician with the concern that a patient has developed a pulmonary embolism. Which of the following symptoms has the nurse most likely observed?
A. The patient is somnolent with decreased response to the family.
B. The patient suddenly complains of chest pain and shortness of breath.
C. The patient has developed a wet cough and the nurse hears crackles on auscultation of the lungs.
D. The patient has a fever, chills, and loss of appetite.
Correct Answer: B. The patient suddenly complains of chest pain and shortness of breath.
Typical symptoms of pulmonary embolism include chest pain, shortness of breath, and severe anxiety. The physician should be notified immediately. Clinical signs and symptoms for pulmonary embolism are nonspecific; therefore, patients suspected of having pulmonary embolism—because of unexplained dyspnea, tachypnea, or chest pain or the presence of risk factors for pulmonary embolism—must undergo diagnostic tests until the diagnosis is ascertained or eliminated or an alternative diagnosis is confirmed.
Option A: The patient may present atypical symptoms based on risk factors, such as delirium or a decreasing level of consciousness.
Option B: The diagnosis of pulmonary embolism should be sought actively in patients with respiratory symptoms UNEXPLAINED by an alternative diagnosis; symptoms may include productive cough and wheezing.
Option D: A patient with fever, chills, and loss of appetite may be developing pneumonia. Fever of less than 39°C (102.2ºF) may be present in 14% of patients; however, a temperature higher than 39.5°C (103.1º) F is not from a pulmonary embolism.