DVT & PE

Question 1

How is superficial thrombophlebitis defined?

Answer 1

less severe and on the surface of the skin

Question 2

How is DVT thrombophlebitis defined?

Answer 2

in the muscle, life-threatening, & an inflammatory condition

Question 3

What are the 3 main causes of a clot forming?

Answer 3

circulatory stasis, vascular damage, & hypercoagulability

Question 4

What is happening in circulatory stasis? What are 2 examples?

Answer 4

reduce blood flow & cause RBCs to clump together
Examples: atrial fibrillation, immobility

Question 5

What is happening in vascular damage? What are 2 examples?

Answer 5

blood vessel injury & starts inflammatory process
examples: trauma & orthopedic surgery

Question 6

What is happening in hypercoagulability? What are 2 examples?

Answer 6

increased clotting
sepsis & smoking

Question 7

What are the 2 medications that are risk factors for DVT?

Answer 7

estrogen & birth control

Question 8

What 6 cardiovascular conditions are risk factors for DVT?

Answer 8

A-fib, CVA, HTN, CAD, MI, & PVD

Question 9

What are the 6 key symptoms that are seen with DVT?

Answer 9

asymptomatic, pain, tenderness, erythema, warmth, & edema

Question 10

What is the main diagnostic test for when a patient has a DVT?

Answer 10

obtaining a positive D-dimer & confirming with an ultrasound

Question 11

What is performed to identify specific pain? What do you need to consider if a DVT is present?

Answer 11

Homan’s sign
Do not perform if a DVT is present

Question 12

What is a positive Homan’s sign?

Answer 12

pain in the posterior calf or knee with forced dorsiflexion of the foot

Question 13

What type of pain is seen in patients who have pulmonary embolism?

Answer 13

sharp upper abdomen/thoracic pain

Question 14

What are the 3 types of breathing patterns seen in pulmonary embolism?

Answer 14

dyspnea, crackles, rhonchi

Question 15

What type of cough is seen with pulmonary embolism?

Answer 15

cough with hemoptysis

Question 16

What lab result for PT indicates the presence of blood clots?

Answer 16

less than 11 seconds

Question 17

What lab result for aPTT indicates the presence of blood clots?

Answer 17

less than 30 seconds

Question 18

What is the difference between a V/Q scan & a spiral CT?

Answer 18

V/Q scan would be given if a patient is allergic to the CT contrast

Question 19

What 3 things can cause a blockage in pulmonary embolus?

Answer 19

air embolus, fat, & thrombus

Question 20

What are the 5 prevention measures used for VTE prophylaxis?

Answer 20

1. medications like heparin
2. positioning like elevating the feet
3. movement
4. TED hoses
5. SCDs

Question 21

Which 3 tests would be ordered if someone were suspected of a pulmonary embolus?

Answer 21

D. dimer, CT scan with contrast or V/Q scan, and Doppler ultrasound.

Question 22

If a patient has low results for their aPTT, which 2 things would we need to do with their heparin?

Answer 22

Give bolus & increase dose

Question 23

If a patient has high results for their aPTT, which 2 things could you do with their heparin?

Answer 23

hold or decrease the dose

Question 24

If aPTT is within range, how many times does it need to be within range for it to be therapeutic?

Answer 24

2 days

Question 25

Which 2 medications do you not take with Lovenox?

Answer 25

aspirin & NSAIDs

Question 26

What is the therapeutic INR level?

Answer 26

2-3

Question 27

Which patients would you not use direct thrombin inhibitor medications in?

Answer 27

renal disease

Question 28

When is the antidote for direct thrombin inhibitors used?

Answer 28

life-threatening situations

Question 29

What is the antidote for Factor Xa inhibitors?

Answer 29

Andexanet alfa (Andexxa, Portola)

Question 30

What is the patient at risk of if suddenly discontinued no substitution in place when on a Factor Xa Inhibitor?

Answer 30

risk of an ischemic event

Question 31

Thrombolytic drugs are known as what?

Answer 31

Clot busters

Question 32

NSAIDs & anticoagulants are not what?

Answer 32

clot busters