A nurse caring for a client with pulmonary embolism should anticipate administering which medication?

• A. Furosemide
• B. Dexamethasone
• C. Heparin
• D. Atropine

Answer: (C)

The key idea is that the immediate goal in pulmonary embolism is anticoagulation to prevent the clot from growing and to stop new clots from forming. Heparin fits this role because it acts quickly to inhibit thrombin and factor Xa through antithrombin III, giving rapid control of the clotting process. In acute PE, unfractionated heparin is often started IV so therapy can be precisely titrated and adjusted to reach a therapeutic aPTT. This treatment buys time for the body to dissolve the clot and for further plans, like transitioning to longer-term anticoagulation with warfarin or a DOAC, to prevent recurrence. While on heparin, monitoring is essential to balance preventing clots with the risk of bleeding, and clinicians watch for heparin-induced thrombocytopenia.

The other medications don’t address the underlying clotting issue. Furosemide is a diuretic that reduces fluid overload and preload but doesn’t prevent clot propagation. Dexamethasone is a steroid with no role in treating the embolic clot. Atropine is used for bradycardia and would not treat an embolic event.