DVT Exam A+ Pass Brand New!!

DVT Exam A+ Pass Brand New!! risk factors for DVT - Answer- Smoking Overweight/obese Prolonged bed rest or being immobile for long periods of time Older age (risk increases as age increases) Oral contraceptive use History of a previous DVT Venous status, IV Cath, HTN, varicose veins, hypercoagulability Identify at least 5 risk factors from L.J.'s history. - Answer- 48 pack year smoking history Frequent episodes of atrial flutter or fibrillation 2 previous episodes of DVT Advanced age (70 years old) Borderline high cholesterol (206mg/dL) History of sedentary lifestyle Based on his history, L.J. should have been taking an important medication. What is it and why should he be taking it? - Answer- L.J should have been prescribed an anticoagulant since he has had 2 previous episodes of DVT. This type of medication will prevent the formation of clots and help reduce the chances of getting another DVT. Some examples of anticoagulants that could have been prescribed are Apixaban, Warfarin, and Heparin. Keeping in mind L.J's health history and admitting diagnosis, outline the most important assessments you will make during your physical examination. - Answer- a. Assessment of affected leg- assess for warmth, redness, edema, pain, distal pulses, and capillary refill. Also compare assessment to unaffected leg. b. Obtain baseline vital signs c. Continue to monitor for signs of pulmonary embolism- tachycardia, restlessness, dyspnea, tachypnea, sudden chest pain, cyanosis. d. Mental status- assess for confusion, restlessness, and lethargy What is the most serious complication of DVT? - Answer- The most serious complication is the development of a pulmonary embolism. This happens when the thrombi that originated somewhere in the venous system travels to the lungs and obstructs the pulmonary artery or one of its branches. List at least 8 assessment findings you should monitor closely for in the development of the complication - Answer- 1. Tachycardia 2. Tachypnea 3. Dyspnea 4. Chest pain 5. Diaphoresis 6. Cough 7. Crackles 8. Friction rub 9. Anxiety 10. Hemoptysis 11. Cyanosis 12. Development of PE (Most serious) What does VTE mean? - Answer- VTE stands for venous thromboembolism. VTE encompasses two interrelated conditions, DVT (deep vein thrombosis) and PE (pulmonary embolism). VTE occurs when there is a DVT present, meaning a blood clot has formed in the deep veins of the legs, groin or arm. This clot then dislodges and travels through circulation, eventually lodging into the lungs, and becoming a pulmonary embolism. L.J. asks, "Why do I have to get these shots? Why can't I just get a Coumadin pill to thin my blood?" What would be your response?" a. "Your physician prefers the injections over the pills." b. "The enoxaparin will work to dissolve the blood clot in your leg." c. "It would take the Coumadin pills several days to become effective." d. "Good idea! I will call and ask your physician to switch medications." - Answer- c. "It would take the Coumadin pills several days to become effective." What special techniques do you use when giving the subcutaneous injection of enoxaparin? Select all that apply. a. Rotate injection sites. b. Give the injection near the umbilicus. c. Massage the injection site gently after the injection is given. d. After inserting the needle, do not aspirate before giving the injection. e. Expel the bubble from the prefilled syringe before giving the injection. - Answer- a. Rotate injection sites. d. After inserting the needle, do not aspirate before giving the injection. True or False? Enoxaparin dosage is directed by monitoring aPTT levels - Answer- False. No anticoagulant tests are done routinely in association with low-weight molecular heparins such as Enoxaparin (Lovenox). L.J. asks you how long it will take for the Lovenox injections to dissolve his blood clot. What is your response to him? - Answer- -no anticoag dissolves blood clots; prevents the spread and formation of new ones. The body will naturally dissolve the clot. After providing teaching about anticoagulant therapy, you ask L.J. to teach back to you what he has learned. Which statements indicate a need for further education? Select all that apply. a. "I will not blow my nose really hard." b. "I will brush my teeth gently with a soft toothbrush." c. "I will take aspirin or ibuprofen if I have a headache." d. "I will shave very carefully with my disposable razor." e. "I will put lotion on my skin to keep it from getting too dry." f. "I will purchase and wear a medical alert necklace for blood thinners." g. "I will get help right away if I notice bleeding in my stools or urine or if I have a bad headache or stomach pain." - Answer- c. "I will take aspirin or ibuprofen if I have a headache." d. "I will shave very carefully with my disposable razor." You identify pain as a key issue in the care of L.J. List 4 interventions you will choose for L.J. to address his pain. - Answer- Elevate the affected leg Wear compression stockings at home Get up and walk around regularly. Don't sit for more than 2 hours Don't cross your legs when sitting. Relaxation imagery/non pharm pain interventions