Deep Vein Thrombosis (DVT) Exam A+ Pass

Deep Vein Thrombosis (DVT) Exam A+ Pass Explain the deep vein thrombosis (DVT) - Answer- Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling but also can occur with no symptoms. What are the signs and symptoms? - Answer- - Swelling in the affected leg. Rarely, there's swelling in both legs. - Pain in your leg. The pain often starts in your calf and can feel like cramping or soreness. - Red or discolored skin on the leg. - A feeling of warmth in the affected leg What are the risk factors? - Answer- - Age. Being older than 60 increases your risk of DVT, though it can occur at any age. - Sitting for long periods of time, such as when driving or flying. When your legs remain still for hours, your calf muscles don't contract. Muscle contractions normally help blood circulate. - Prolonged bed rest, such as during a long hospital stay, or paralysis. Blood clots can form in the calves of your legs if your calf muscles don't move for long periods. - Injury or surgery. Injury to your veins or surgery can increase the risk of blood clots. - Pregnancy. Pregnancy increases the pressure in the veins in your pelvis and legs. Women with an inherited clotting disorder are especially at risk. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby. - Birth control pills (oral contraceptives) or hormone replacement therapy. Both can increase your blood's ability to clot. - Being overweight or obese. Being overweight increases the pressure in the veins in your pelvis and legs. - Smoking. Smoking affects blood clotting and circulation, which can increase your risk of DVT. - Cancer. Some forms of cancer increase substances in your blood that cause your blood to clot. Some forms of cancer treatment also increase the risk of blood clots. - Heart failure. This increases your risk of DVT and pulmonary embolism. Because people with heart failure have limited heart and lung function, the symptoms caused by even a small pulmonary embolism are more noticeable. - Inflammatory bowel disease. Bowel diseases, such as Crohn's disease or ulcerative colitis, increase the risk of DVT. - A personal or family history of DVT or PE. If you or someone in your family has had one or both of these, you might be at greater risk of developing DVT. - Genetics. Some people inherit genetic risk factors or disorders, such What labs should you monitor? - Answer- D-dimer blood test. D dimer is a type of protein produced by blood clots. Almost all people with severe DVT have increased blood levels of D dimer. A normal result on a D-dimer test often can help rule out PE. What diagnostic tests should be expected? - Answer- - Doppler ultrasound. The tip of the Doppler transducer is positioned at a 45- to 60-degree angle over the expected location of the artery and angled slowly to identify arterial blood flow. - Computed tomography. Computed tomography provides cross-sectional images of soft tissue and visualizes the area of volume changes to an extremity and the compartment where changes take place. What happens when the disease worsens? - Answer- - Pulmonary embolism (PE). PE is a potentially life-threatening complication associated with DVT. It occurs when a blood vessel in your lung becomes blocked by a blood clot (thrombus) that travels to your lung from another part of your body, usually your leg. It's important to get immediate medical help if you have signs and symptoms of PE. Sudden shortness of breath, chest pain while inhaling or coughing, rapid breathing, rapid pulse, feeling faint or fainting, and coughing up blood may occur with a PE. - Postphlebitic syndrome. Damage to your veins from the blood clot reduces blood flow in the affected areas, causing leg pain and swelling, skin discoloration and skin sores. - Treatment complications. Complications may result from blood thinners used to treat DVTs. Bleeding (hemorrhage) is a worrisome side effect of blood thinners. It's important to have regular blood tests while taking such medications. What key assessments should you perform? - Answer- - Presenting signs and symptoms. If a patient presents with signs and symptoms of DVT, carry out an assessment of general medical history and a physical examination to exclude other causes. - Well's diagnostic algorithm. Because of the unreliability of clinical features, Well's diagnostic algorithm has been validated whereby patients are classified as having a high, intermediate, or low probability of developing DVT. What interventions should you perform? - Answer- - Provide comfort. Elevation of the affected extremity, graduated compression stockings, warm application, and ambulation are adjuncts to the therapy that can remove or reduce discomfort. - Compression therapy. Graduated compression stockings reduce the caliber of the superficial veins in the leg and increase flow in the deep veins; external compression devices and wraps are short stretch elastic wraps that are applied from the toes to the knees in a 50% spiral overlap; intermittent pneumatic compression devices increase blood velocity beyond that produced by the stockings. - Positioning and exercise. When patient is on bed rest, the feet and lower legs should be elevated periodically above the level of the heart, and active and passive leg exercises should be performed to increase venous flow.