Question

A nurse is caring for a client who develops a sudden onset of dyspnea. Which of the following findings should the nurse expect if the client has a pulmonary embolus?

1) Expiratory rhonchi
2) Petechiae over the lower extremities
3) Hemoptysis
4) Flattened neck veins

Answer 1

The nurse should expect to find hemoptysis if the client has a pulmonary embolus, along with other symptoms like rapid breathing, chest pain, and hypoxemia. Expiratory rhonchi, petechiae over the lower extremities, and flattened neck veins are not typical findings associated with pulmonary embolism.

Step-by-step explanation:

If a client develops a sudden onset of dyspnea, and the clinical suspicion is a pulmonary embolus (PE), the nurse should expect certain clinical findings. A PE typically presents with symptoms like shortness of breath, chest pain, rapid breathing, and often a sense of anxiety. One of the most indicative signs of PE is hemoptysis, which is the coughing up of blood. This occurs due to the damage PE causes to the pulmonary vessels and lung tissue.

Other signs and symptoms that can be present in PE include tachycardia, which is an elevated heart rate, hypoxemia as indicated by low oxygen levels in the blood, and abnormal lung sounds like crackles (not expiratory rhonchi) on auscultation. Although petechiae over the lower extremities might be associated with conditions that can cause PE, like deep vein thrombosis (DVT), they are not a direct symptom of pulmonary embolism itself. Flattened neck veins are not characteristic of PE; in fact, if significant right heart strain occurs due to a large embolus, the jugular veins may become distended.