Pulmonary Embolism — NCLEX Cheat Sheet
Clot blocks lung arteryAlso known as: PE · blood clot in lung · lung clot
Use this quick-reference guide to spot, treat, and prevent Pulmonary Embolism on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
🩺 Signs
- Sudden SOB, sharp chest pain
- Tachycardia, tachypnea, ↓ O₂
- Anxiety, hemoptysis, cough
✅ Do
- O₂ high-flow, semi-Fowler's
- Anticoag heparin, thrombolytics
- IV access, monitor, stay calm
🚩 Report
- Sudden death, ↓ BP, shock
🎓 Teach
- Prevent: ambulate, SCDs, AC
- Risk: DVT, surgery, immobility
📚 Pulmonary Embolism — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Sudden onset of dyspnea and sharp pleuritic chest pain are the most common presenting signs.
- Tachypnea, tachycardia, anxiety, and a sense of impending doom are frequent.
- Hypoxemia, cough, and sometimes hemoptysis occur as lung tissue is deprived of perfusion.
- A large saddle embolus can cause hypotension, jugular vein distention, and obstructive shock.
- ABGs often show respiratory alkalosis with hypoxemia and a low PaCO2 from hyperventilation.
- Spiral CT pulmonary angiography is the gold-standard diagnostic test; a positive D-dimer is sensitive but not specific.
Nursing priorities
What to do, in order- Apply high-flow oxygen and place the patient in high Fowler's position immediately.
- Notify the rapid response or provider and prepare for anticoagulation.
- Administer anticoagulants (heparin) as ordered, and thrombolytics for massive PE with hemodynamic instability.
- Establish IV access and continuously monitor cardiac rhythm, oxygenation, and vital signs.
- Keep the patient calm and on bed rest to reduce oxygen demand and clot dislodgement.
Red flags — report now
Escalate immediately- Sudden severe dyspnea, hypotension, or loss of consciousness signals a massive PE, call for emergency help.
- Falling blood pressure with rising heart rate indicates obstructive shock and impending arrest.
- Signs of bleeding during anticoagulant or thrombolytic therapy require immediate evaluation.
- Never massage the legs of a patient with suspected DVT, which can dislodge the clot.
Labs & values
Numbers to know- D-dimer elevated (normal <0.5 mcg/mL); sensitive but not specific
- ABG: hypoxemia (PaO2 <80) and respiratory alkalosis (low PaCO2)
- Monitor aPTT for heparin (therapeutic 1.5-2.5x control)
Patient teaching
What patients must know- Prevent clots by ambulating early after surgery, doing leg exercises, and staying hydrated.
- Avoid prolonged immobility, take stretch breaks on long trips, and use prescribed compression devices.
- While on anticoagulants, report any unusual bleeding or bruising and attend lab monitoring.
❓ Pulmonary Embolism: NCLEX FAQs
What are the priority nursing interventions for Pulmonary Embolism?
Apply high-flow oxygen and place the patient in high Fowler's position immediately. Notify the rapid response or provider and prepare for anticoagulation. Administer anticoagulants (heparin) as ordered, and thrombolytics for massive PE with hemodynamic instability. Establish IV access and continuously monitor cardiac rhythm, oxygenation, and vital signs.
What are the warning signs of Pulmonary Embolism a nurse must report?
Sudden severe dyspnea, hypotension, or loss of consciousness signals a massive PE, call for emergency help. Falling blood pressure with rising heart rate indicates obstructive shock and impending arrest. Signs of bleeding during anticoagulant or thrombolytic therapy require immediate evaluation. Never massage the legs of a patient with suspected DVT, which can dislodge the clot.
What do I need to know about Pulmonary Embolism for the NCLEX?
Sudden onset of dyspnea and sharp pleuritic chest pain are the most common presenting signs. Tachypnea, tachycardia, anxiety, and a sense of impending doom are frequent. Hypoxemia, cough, and sometimes hemoptysis occur as lung tissue is deprived of perfusion. A large saddle embolus can cause hypotension, jugular vein distention, and obstructive shock.
What patient teaching is important for Pulmonary Embolism?
Prevent clots by ambulating early after surgery, doing leg exercises, and staying hydrated. Avoid prolonged immobility, take stretch breaks on long trips, and use prescribed compression devices. While on anticoagulants, report any unusual bleeding or bruising and attend lab monitoring.
Quick Tip
Sudden onset of dyspnea and sharp pleuritic chest pain are the most common presenting signs.
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