DVT/PE Flashcards

1
Q

A patient in critical care, with cancer, stroke, preg, HF, MI, previous VTE, prolonged immobility, renal failure, or hypercoag state is in what category for a VTE?

A

High risk

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2
Q

How do you prevent a VTE in a low risk patient?

A

Pharm, early ambulation, and SCD’s

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3
Q

How do we prevent VTE in the hospital setting for a high risk patient?

A

Pharm (LMWH or UFH)

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4
Q

Does a patient need to continue LMWH or UFH at home? Nursing facility?

A

NO need to continue at home

If absolutely necessary, you can continue if they go to SNF

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5
Q

When we prescribe heparin, what should we always look out for?

A

Heparin induced thrombocytopenia

Use the 4 T’s calculator to evaluate risk

(50% reduction in PLT) → stop all heparin!!!

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6
Q

If a patient on heparin and their platelets drop by 50%, what should we do?

A

Stop ALL HEPARIN PRODUCTS!!! Including heparin-locks

Use Arixtra

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7
Q

What are some exam findings we would see with a VTE?

A

Palpable cord, +Homan’s sign, edema, and discoloration

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8
Q

If a patient has a low Well’s criteria – what should we do?

A

Get an ultrasound and a D-Dimer

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9
Q

How do we treat a DVT in the hospital (classically)?

A

Admit → confirm with US → anticoag (Heparin + warfarin on day one!!!!) → have a case manager to help with home SQ injections

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10
Q

How long do we continue the heparin or lovenox?

A

MINIMUM 5 DAYS

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11
Q

What are some of the new changes to DVT treatment?

A

Direct oral agents (Rivaroxaban and Apixaban ONLY)
*No HEPARIN OVERLAP

Must be taken several times a day (can’t skip doses!) no eGFR less than 30

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12
Q

If a patient presents with dyspnea, pleuritic chest pain, cough, orthopnea, wheezing, and hemoptysis – what type of PE is this?

A

Submassive

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