Clinical Manifestations of PE
Clinical Manifestations of PE ( 5 Questions)
A nurse is reviewing the laboratory results of a client who has a suspected pulmonary embolism.
Which of the following findings indicates an increased risk for clot formation?
D-dimer is a fibrin degradation product that is released when a blood clot is dissolved. A high level of D-dimer indicates an increased likelihood of blood clots, such as pulmonary embolism. A normal D-dimer level (below 500 ng/mL) can rule out pulmonary embolism in patients with low or moderate clinical pretest probability.
Decreased platelet count is not associated with pulmonary embolism. Platelet count may decrease after pulmonary embolism due to platelet activation and consumption, but it is not a risk factor for clot formation.
Low hematocrit level is not associated with pulmonary embolism.
Hematocrit level may decrease due to blood loss, hemolysis, or dilution, but it does not affect the risk of clot formation.
High prothrombin time is not associated with pulmonary embolism.
Prothrombin time measures the time it takes for blood to clot in the presence of vitamin K-dependent factors.
The correct answer is choice A. Elevated D-dimer level.
D-dimer is a fibrin degradation product that is released when a blood clot is dissolved. A high level of D-dimer indicates an increased likelihood of blood clots, such as pulmonary embolism. A normal D-dimer level (below 500 ng/mL) can rule out pulmonary embolism in patients with low or moderate clinical pretest probability.
Choice B is wrong because decreased platelet count is not associated with pulmonary embolism. Platelet count may decrease after pulmonary embolism due to platelet activation and consumption, but it is not a risk factor for clot formation.
Choice C is wrong because low hematocrit level is not associated with pulmonary embolism.
Hematocrit level may decrease due to blood loss, hemolysis, or dilution, but it does not affect the risk of clot formation.
Choice D is wrong because high prothrombin time is not associated with pulmonary embolism.
Prothrombin time measures the time it takes for blood to clot in the presence of vitamin K-dependent factors.
A high prothrombin time indicates a deficiency or inhibition of these factors, which may increase the risk of bleeding, not clotting.
Normal ranges for D-dimer, platelet count, hematocrit, and prothrombin time may vary depending on the laboratory and the method used, but generally they are:
• D-dimer: <500 ng/mL
• Platelet count: 150-450 x 10^9/L
• Hematocrit: 36-48% for females, 40-54% for males
• Prothrombin time: 11-13 seconds