Questions With Complete Solutions
A nurse is caring for a patient with a diagnosis of deep venous
thrombosis (DVT). The patient receives a prescription for 30 mg
enoxaparin. Which injection site should the nurse use to
administer this medication safely?
Buttock, upper outer quadrant
Abdomen, anterior-lateral aspect
Back of the arm, 2 inches away from a mole
Anterolateral thigh, with no scar tissue nearby Correct Answers
Abdomen, anterior-lateral aspect
Enoxaparin is a low-molecular-weight (LMW) heparin that is
given as a deep subcutaneous injection in the right and left
anterolateral abdomen. Enoxaparin will not be given in the
upper quadrant of the buttock. All subcutaneous injections
should be given away from scars, lesions, or moles.
p. 820
A patient admitted to the health care facility with venous
thromboembolism (VTE) is prescribed unfractionated heparin,
to be administered subcutaneously. What technique should the
nurse use when administering the medication? Select all that
apply.
,1. Inject deep into abdominal fatty tissue.
2. Hold skinfold during injection.
3. Release skinfold after removing needle.
4. Avoid aspiration.
5. Rub site after injection. Correct Answers 1. Inject deep into
abdominal fatty tissue.
2. Hold skinfold during injection.
4. Avoid aspiration.
A patient develops edema following peripheral artery bypass
surgery. The nurse should place the patient in what position?
Sitting position
Supine position
Side-lying position
Knee-flexed position Correct Answers Supine position
Edema of the lower extremity may occur after peripheral artery
bypass surgery due to an excessive volume of fluid
accumulation in the tissues. The supine position with elevating
the leg above heart level helps reduce edema. The sitting
position will increase edema. The side-lying position will not
,help in venous return. The knee-flexed position may increase
edema.
p. 807
A patient develops postthrombotic syndrome. The nurse assesses
lipodermatosclerosis, which has what hallmark characteristic?
Leathery, brown-colored skin
Swollen leg
Blue-colored skin
Presence of cordlike veins Correct Answers Leathery, brown-
colored skin
In lipodermatosclerosis, the skin on the lower leg is scarred and
leathery, with brown discoloration. A swollen, blue, painful leg,
or phlegmasia cerulea dolens, is a rare complication that may
develop in a patient in the advanced stages of cancer. The
presence of cordlike veins is associated with superficial vein
thrombosis. p. 818
A patient experiences chronic ischemic rest pain that lasts more
than 2 weeks and gangrene of the leg as a result of peripheral
artery disease (PAD). The patient is not a candidate for
revascularization bypass surgery. The nurse expects a
prescription for what?
Cilostazol
, Bosentan
Plasminogen activator
Percutaneous transluminal angioplasty (PTA) Correct Answers
PTA
The patient's clinical manifestations indicate critical limb
ischemia. Percutaneous transluminal angioplasty is
recommended for patients with critical limb ischemia who are
not candidates for revascularization bypass surgery. Cilostazol is
used to treat Buerger's disease. Bosentan is an endothelin
receptor antagonist and is used to treat Raynaud's phenomenon.
Plasminogen activator is recommended for the patient if surgical
thrombectomy is not possible.
p. 805
A patient experiences pain in the calf while exercising and
reports that the pain disappears after a few minutes of resting.
The nurse recognizes the finding as consistent with what
condition?
Venous obstruction in the leg
Claudication resulting from venous abnormalities
Ischemia resulting from complete blockage of an artery