A patient on telemetry with sudden shortness of breath and chest pain is suspected of PE. What are the immediate nursing actions?

• A. Administer oxygen if needed, maintain hemodynamic support as ordered, notify physician, prepare for diagnostic imaging and anticoagulation as ordered.
• B. Start antibiotics immediately.
• C. Place patient in Trendelenburg and delay imaging.
• D. Administer diuretics.

Answer: (A)

In a patient with sudden shortness of breath and chest pain suspected to be a pulmonary embolism, the priority is rapid stabilization and coordination of diagnostic and therapeutic steps. Start by ensuring adequate oxygenation—administer oxygen as needed to correct hypoxemia and monitor respiratory status closely. Simultaneously, provide hemodynamic support as ordered to maintain perfusion, with IV access in place and vital signs continuously monitored. Notify the physician immediately so the team can expedite definitive imaging, such as CT pulmonary angiography, and initiate anticoagulation as soon as it’s deemed safe. These steps address the immediate threat by stabilizing breathing and circulation, confirming the diagnosis, and beginning treatment to prevent clot propagation. Other interventions like starting antibiotics, placing the patient Trendelenburg, or giving diuretics do not address the acute crisis of suspected PE and are not appropriate unless specifically indicated for another reason.