Pulmonary Embolism Diagnosis & Care Plan – devshopsimplenursing

Pulmonary Embolism Diagnosis & Care Plan

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By Amanda Thomas
Updated On May 2025
Medically Reviewed by:
Angela Slater FNP, RN
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When a patient can’t catch their breath — and it’s not anxiety — every second counts. 

Pulmonary embolism is fast, serious, and often sneaky. Nurses need to think critically, act quickly, and recognize red flags when they appear. 

A nursing diagnosis for pulmonary embolism (PE) helps guide interventions that can save lives, from stabilizing oxygen levels to preventing further clots. With PE, “watch and wait” isn’t an option. 

Early action is everything.

What is Pulmonary Embolism? 

PE occurs when a blood clot, often originating from the deep veins in the legs (deep vein thrombosis or DVT), travels to the lungs and obstructs one or more pulmonary arteries. 

This blockage impedes blood flow, leading to impaired gas exchange and increased strain on the heart. 

Signs and Symptoms of Pulmonary Embolism 

Pulmonary embolism can present subtly or strike suddenly, which makes early recognition critical. 

Pay close attention to these signs and symptoms.

  • Sudden shortness of breath (dyspnea): Difficulty breathing that appears abruptly
  • Chest pain: Sharp or stabbing pain that may worsen with deep breaths or coughing
  • Cough: Possibly producing bloody sputum (hemoptysis)
  • Rapid heart rate (tachycardia): Increased heart rate as the body attempts to compensate for reduced oxygenation
  • Lightheadedness or dizziness: Due to decreased oxygen levels
  • Leg pain or swelling: Often in the calf, indicative of DVT

Nursing Process for Pulmonary Embolism 

From the initial assessment to implementing pulmonary embolism nursing interventions, every step is critical for stabilizing the patient and preventing serious complications. 

This is where clinical judgment meets rapid response, guiding nurses through assessment, diagnosis, and action.

Nursing Assessment 

Pulmonary embolism doesn’t always show up with textbook symptoms. 

Nurses must catch subtle changes before they become life-threatening. 

Patient History and Risk Factors 

  • Recent immobility: Prolonged bed rest, long flights, or surgeries
  • Medical history: Previous DVT, PE, cancer, heart disease, or clotting disorders
  • Lifestyle factors: Smoking, obesity, or use of hormone replacement therapy

Physical Assessment 

  • Vital signs: Monitor for tachycardia, hypotension, and decreased oxygen saturation.
  • Respiratory examination: Observe for increased respiratory rate, use of accessory muscles, and cyanosis.
  • Cardiovascular assessment: Assess for jugular vein distension and heart sounds. 

 Diagnostic Tests and Lab Work 

  • D-dimer test: Elevated levels may indicate clot formation
  • Imaging studies: CT pulmonary angiography is the gold standard for diagnosing PE.
  • Arterial blood gases (ABGs): Assess oxygenation and acid-base balance. 

Nursing Diagnosis for Pulmonary Embolism 

The nursing diagnosis helps prioritize care and guide interventions that protect the lungs and heart.

Impaired Gas Exchange 

Disruption in the oxygen and carbon dioxide exchange at the alveolar-capillary level 

Related Factors

  • Obstruction of pulmonary arterial blood flow by embolus 
  • Ventilation-perfusion mismatch 

Risk Factors

  • Prolonged immobility 
  • Surgical procedures, especially orthopedic surgeries 
  • History of DVT 
  • Obesity 
  • Smoking 
  • Use of oral contraceptives or hormone replacement therapy 
  • Pregnancy or postpartum status 
  • Clotting disorders 
  • Cancer 
  • Varicose veins 

Acute Pain 

Sudden onset of discomfort or distress in response to tissue injury

Related Factors 

  • Ischemic tissue injury secondary to pulmonary embolism 

Risk Factors

  • Postoperative patients
  • Individuals with a history of thromboembolic events

Decreased Cardiac Output 

Inadequate blood pumped by the heart to meet metabolic demands 

Related Factors 

  • Increased pulmonary vascular resistance due to embolism 

Risk Factors 

  • Cardiovascular diseases 
  • Chronic lung conditions 
  • Advanced age

Dyspnea 

Inspiration and/or expiration that does not provide adequate ventilation

Related Factors

  • Pain and anxiety associated with pulmonary embolism 

Risk Factors: 

  • Respiratory muscle fatigue
  • Neuromuscular disorders
  • Severe anxiety or panic disorders

Venous Stasis 

Impaired Peripheral Venous Return 

The inability of the peripheral venous system to return blood adequately from the extremities to the heart, resulting in venous pooling

Related Factors
  • Structural and/or functional valve deficiency in the veins 
  • Prolonged immobility or sedentary lifestyle 
  • Obesity 
  • Advanced age 
  • Pregnancy 
  • Peripheral venous thrombosis
  • Prolonged periods of standing or sitting 
  • Heredity 
As evidenced by
  • Peripheral edema
  • Pain or aching in the extremities 
  • Development of venous ulcers 
  • Skin changes such as discoloration or dermatitis

Hemoptysis 

Risk for Bleeding 

At risk for a decrease in blood volume that may compromise health

Related Factors
Risk Factors 
  • History of bleeding disorders
  • Recent surgery or trauma
  • Concurrent use of medications affecting coagulation

Risk for Deep Vein Thrombosis (DVT) 

The susceptibility to developing a blood clot in the deep veins, which can impede circulation and pose life-threatening complications

Risk Factors: 

  • Prolonged immobility: Extended bed rest, long-duration travel, or post-operative recovery leading to decreased blood flow
  • Surgical procedures: Especially orthopedic surgeries involving the lower extremities or pelvis
  • Medical conditions: Such as cancer, heart failure, or clotting disorders
  • Lifestyle factors: Obesity, smoking, or use of hormone replacement therapy

Anxiety 

Related Factors

  • Fear of health status change and potential life-threatening condition

Risk Factors

  • Previous experiences with severe illness
  • Lack of knowledge about the condition
  • Perceived threat to health or life

Nursing Goals and Expected Outcomes 

These nursing goals lay the foundation for care that’s proactive, not just reactive.

Goals

  • Ensure adequate oxygenation and tissue perfusion. 
  • Stabilize hemodynamic status. 
  • Alleviate pain and discomfort. 
  • Prevent complications and recurrence. 
  • Educate patients and families for effective self-management post-discharge.

Expected Outcomes

  • Patients will maintain oxygen saturation levels within normal limits 
  • Patients will exhibit stable vital signs indicative of hemodynamic stability 
  • Patients will report reduced pain levels 
  • Patients will demonstrate understanding of preventive measures and adhere to prescribed therapies

Nursing Interventions for Pulmonary Embolism 

These interventions help you stabilize the patient, support their breathing, prevent new clots from forming, and teach them how to stay safe after discharge.

Provide Oxygen Therapy and Monitor Respiratory Status 

  • Administer supplemental oxygen to maintain adequate oxygenation.  
  • Monitor respiratory rate, depth, and effort regularly. 
  • Measure ABGs to evaluate gas exchange efficiency. 

Support Anticoagulation Therapy (Heparin, Warfarin) 

  • Administer anticoagulants as prescribed to prevent further clot formation. 
  • Monitor coagulation parameters (e.g., INR, aPTT) to ensure therapeutic levels. 
  • Observe for signs of bleeding or adverse reactions. 

Promote Mobility and Prevent Further Clot Formation

  • Encourage early ambulation as tolerated to enhance circulation. 
  • Implement leg exercises and range-of-motion activities for bedridden patients. 
  • Apply compression devices or stockings to reduce venous stasis. 

Educate Patient and Family on Long-Term Management 

  • Provide information on medication adherence, including dosage, timing, and potential side effects. 
  • Discuss lifestyle modifications such as smoking cessation, weight management, and regular exercise. 
  • Emphasize the importance of follow-up appointments and monitoring for recurrence. 

Nursing Care Plans for Pulmonary Embolism 

Every symptom tells a story, and a good care plan reads between the lines. 

With pulmonary embolism, there’s more than one issue to tackle: impaired gas exchange, sharp chest pain, low cardiac output, and the emotional weight of it all. These targeted nursing care plans help nurses prioritize, personalize, and take the right steps to improve patient outcomes..

Care Plan #1 

Diagnostic Statement 

Impaired gas exchange related to ventilation-perfusion mismatch secondary to pulmonary embolism

Expected Outcomes 

  • Patient will maintain oxygen saturation above 92%
  • Patient will exhibit normal respiratory rate and rhythm

Assessment 

  • Monitor oxygen saturation and ABG results. 
  • Assess for signs of hypoxia, such as confusion or restlessness. 

Interventions 

  • Administer oxygen therapy as needed. 
  • Position patient in semi-Fowler’s to facilitate lung expansion. 
  • Encourage deep breathing exercises and the use of incentive spirometry. 

Care Plan #2 

Diagnostic Statement 

Acute pain related to ischemic tissue injury secondary to pulmonary embolism

Expected Outcomes 

  • Patient will report pain relief as evidenced by a pain score of 3 or less on a 0-10 scale
  • Patient will demonstrate improved comfort and ability to participate in care activities

Assessment 

  • Evaluate pain characteristics, including location, intensity, and duration. 
  • Monitor vital signs for indicators of pain, such as increased heart rate or blood pressure. 

Interventions 

  • Administer analgesics as prescribed, monitoring for effectiveness and side effects. 
  • Apply non-pharmacological pain relief methods, such as relaxation techniques. 
  • Provide emotional support and reassurance to alleviate anxiety-related pain. 

Care Plan #3 

Diagnostic Statement 

Decreased cardiac output related to increased pulmonary vascular resistance secondary to pulmonary embolism

Expected Outcomes 

  • Patient will maintain blood pressure and heart rate within normal ranges
  • Patient will exhibit signs of adequate tissue perfusion, such as warm extremities and normal capillary refill

Assessment 

  • Monitor blood pressure, heart rate, and rhythm. 
  • Assess for signs of decreased perfusion, including cool, clammy skin and diminished pulses. 

Interventions 

  • Administer medications as prescribed to support cardiac function.
  • Monitor fluid balance, avoiding both overload and deficit. 
  • Position the patient to promote venous return and reduce cardiac workload. 

Preventing Pulmonary Embolism Recurrence 

Recurrence is common, but preventable with the right support. 

Nurses play a key role in helping patients stick to anticoagulation therapy, make smart lifestyle changes, and recognize red flags before they escalate. Prevention is a team effort, and it starts before discharge.

  • Encourage adherence to anticoagulant therapy and regular monitoring. 
  • Promote lifestyle changes to reduce risk factors, such as maintaining a healthy weight and staying active. 
  • Educate on recognizing early signs of DVT and PE for prompt intervention. 

Patient Education and Discharge Planning 

Once the crisis phase is over, patients need more than meds and a follow-up date. 

They need clear instructions, confidence in what comes next, and tools to manage their health at home.

  • Review medication regimen, including purpose, dosage, and potential side effects. 
  • Provide instructions on activity levels, emphasizing gradual increase as tolerated. 
  • Schedule follow-up appointments and necessary laboratory tests. 
  • Offer resources for smoking cessation and dietary counseling if applicable. 

Recommended Resources on Pulmonary Embolism 

Need a little backup? 

These trusted sources go deeper into guidelines, pathophysiology, and evidence-based care.

Nursing Care Plan Resources

Stabilizing Patients Through Focused Nursing Care

For many patients, a pulmonary embolism is one of the scariest moments of their lives. 

What starts as a high-stress emergency becomes a turning point when nurses step in with calm, focused support. Quick action stabilizes the crisis, but a steady presence, clear communication, and attention to detail guide the rest of the recovery process. 

References and Sources 

Deaton, J. G., & Nappe, T. M. (2022, July 18). Warfarin Toxicity – StatPearls. NCBI. Retrieved March 27, 2025. 

Erythropoulou-Kaltsidou, A., Alkagiet, S., & Tziomalos, K. (2020). New guidelines for the diagnosis and management of pulmonary embolism: Key changes. World Journal of Cardiology, 12(5), 161–166. 

Fernandes, C.J., Luppino Assad, A.P., Alves-Jr., J.L., Jardim, C., & de Souza, R. (2019). Pulmonary Embolism and Gas Exchange. Respiration, 98. 

Gulanick, M., & Myers, J. L. (2021). Nursing care plans: Diagnoses, interventions, and outcomes (10th ed.). Elsevier.   

Hanigan, S., & Barnes, G. D. (2019, October). Managing Anticoagulant-related Bleeding in Patients with Venous Thromboembolism. American College of Cardiology. 

Ouellette, D. R., & Mosenifar, Z. (2020, September 18). Pulmonary Embolism (PE): Practice Essentials, Background, Anatomy. Medscape Reference. Retrieved March 27, 2025. 

Tran, A., Redley, M., & de Wit, K. (2021, January). The psychological impact of pulmonary embolism: A mixed-methods study. Research and Practice in Thrombosis and Haemostasis, 5(2), 301-307. 

Vyas, V., Sankari, A., & Goyal, A. (2024). Acute pulmonary embolism. In StatPearls. StatPearls Publishing. Retrieved March 27, 2025.