Deep Venous Thrombosis

Question 1

What percentage of patients get a deep venous thrombosis?

Answer 1

10-20%

Question 2

What is the number one cause of a deep venous thrombosis?

Answer 2

immobility

Question 3

If the virchow triad occurs what happens?

Answer 3

This is the perfect situation for a DVT

Question 4

What is the Virchow triad?

Answer 4

(E) -Endothelial damage
(V) -Venous Stasis
(A) -Altered coagulation

Question 5

In the Virchow triad what does the E in EVA stand for?

Answer 5

Endothelial damage

Question 6

In the Virchow triad what does the V in EVA stand for?

Answer 6

Venous Stasis

Question 7

In the Virchow triad what does the A in EVA stand for?

Answer 7

Altered coagulation

Question 8

In a deep venous thrombosis where does the clot form?

Answer 8

On the wall of the deep vein

Question 9

A DVT is a common complication of these three things:

Answer 9

Hospitalization
Surgery
Orthopedic procedures

Question 10

Why are risks increased for DVTs when a patient has an othropedic, abdominal, or thoracic surgery?

Answer 10

The incisions are larger

Question 11

Why is smoking a risk factor to develop a DVT?

Answer 11

It restricts circulation

Question 12

If a person exhibits on of the risk factors on the list and takes birth control what is likely to happen?

Answer 12

They are a ticking time bomb for a DVT

Question 13

Why is a person at risk for a DVT when they have a catheter in their central vein?

Answer 13

Blood cells clump around the catheter and can occlude the line. This clump of cells can end up forming a clot.

Question 14

Which patient is at highest risk for a venous thromboembolism?
A. A 50-year-old postoperative patient
B. A 25-year-old patient with a central venous catheter in place to treat septicemia
C. A 71-year-old otherwise healthy older adult
D. A pregnant 30-year-old woman due in two weeks

Answer 14

B. A 25-year-old patient with a central venous catheter in place to treat septicemia.

This patient has two risk factors.

Question 15

As a complication of a DVT venous ulcers can be described as:

Answer 15

A reddened clean edged ulcer right about the ankle. Can be large due to lack of circulation. It typically is shallow with a lack of pain.

Question 16

Why would venous gangrene be a complication of a DVT?

Answer 16

Blood blood due to a blockage that is created by the DVT

Question 17

What is varicosities?

Answer 17

A complication of a DVT described as bulging veins.

Question 18

What are the symptoms of a present DVT?

Answer 18

Calf pain
Tenderness
Swelling
Warmth
Erythema (redness)

Question 19

If a patient has a high D-dimer test what does that mean?

Answer 19

They have a blood clot

Question 20

What is an ascending contrast venography?

Answer 20

A test where dye is placed into the vein to see if it goes all the way through

Question 21

As a prophylaxis treatment for a DVT medication is used?

Answer 21

Low molecular weight heparin (enoxoparin)

Question 22

What is the number a patient wants to be between to maintain their aPTT levels?

Answer 22

1.5-2x control

Question 23

What is give with warfarin for the first 4-5 days?

Answer 23

IV heparin

Question 24

What are the doses of warfarin adjusted for?

Answer 24

To maintain an INR of 2.0-3.0

Question 25

A patient takes warfarin for at least how many months?

Answer 25

3

Question 26

When should the patient be taken their warfarin?

Answer 26

between 5-6 around dinner time

Question 27

What is a venous thrombectomy?

Answer 27

When the vein is opened and the clot is removed.

Question 28

Where is a filter placed if a patient has recurrent thrombosis?

Answer 28

In the Inferior Vena Cava

Question 29

What happens during a vein ligation?

Answer 29

The affected vein is tied off.

Question 30

When elevating a patients leg and they have a DVT what should you NOT do?

Answer 30

Elevate the foot of the bed!

Place the foot on a pillow for elevation.

Question 31

If a patient is on extremity rest due to a DVT how do they use the bathroom?

Answer 31

Bedside commode or bedpan only

Question 32

When permitted to return to activity what kind of clothing should the patient avoid?

Answer 32

Tight fitting

Question 33

Where should you not put pressure or pillows in terms of someones leg?

Answer 33

The back of the knee.

Question 34

When trying to prevent a DVT why would you want to assess IV sites?

Answer 34

If there is any redness you need to change it to prevent clot formation.

Question 35

What does thrombosis will not embolism mean?

Answer 35

The blood clot won’t move

Question 36

True or False:

It is not an emergency if a patient with a DVT complains of chest pain.

Answer 36

False:

the thrombosis may have moved.

Question 37

Why is it important to make where you measured the patients leg as well as document it?

Answer 37

So the next nurse can accurately see if the swelling has increased or decreased.

Question 38

True or False:

You should put cold packs on a persons calf who has a DVT there.

Answer 38

False:

Only use warm, moist heat

Question 39

Why is it important to encourage frequent position changes and assess skin frequently.

Answer 39

Skin breakdown can occur rapidly

Question 40

What does it mean by manage limb care?

Answer 40

Encourage pumping and flexing of feet so venous pooling doesn’t occur.

Question 41

Why is it important to document that the patient verbalized the warning signs of DVTs?

Answer 41

Most patients are returning to the hospital due to a DVT that was made at home

Question 42

The nurse teaches the family of an older patient who is at risk for developing a deep venous thrombosis about prevention of the condition. Which of the following will the nurse include in teaching?

1. Place pillows under the knees so that hips are flexed.
2. Apply elastic hose if swelling develops
3. Position client to promote venous return.
4. Keep feet squarely on the flood when sitting in a chair.

Answer 42

2. Apply elastic hose if swelling develops