Ineffective Tissue Perfusion:: Thrombi and Emboli Flashcards
What is the primary difference between a thrombus and an embolus?
A) A thrombus is mobile, while an embolus is stationary
B) A thrombus is a solid mass, while an embolus is a gas
C) A thrombus is a stationary blood clot, while an embolus is a clot that has broken loose and traveled
D) A thrombus is only composed of fibrin, while an embolus contains platelets
C) A thrombus is a stationary blood clot, while an embolus is a clot that has broken loose and traveled
Rationale: A thrombus is a stationary clot that forms in a blood vessel, whereas an embolus is a portion or all of a thrombus that detaches and moves through circulation, potentially lodging in a smaller vessel.
What are the three components of Virchow’s Triad that contribute to thrombosis?
A) Hypertension, hyperlipidemia, hyperglycemia
B) Endothelial injury, circulatory stasis, hypercoagulability
C) Tachycardia, hypovolemia, inflammation
D) Dehydration, anemia, leukocytosis
B) Endothelial injury, circulatory stasis, hypercoagulability
Rationale: Virchow’s Triad consists of three major factors that contribute to thrombosis:
Endothelial injury – damage to the vessel wall
Circulatory stasis – slow or stagnant blood flow
Hypercoagulability – increased clotting tendency
Which of the following is a common diagnostic tool used to detect thrombi or emboli?
A) Spirometry
B) Ultrasound
C) Colonoscopy
D) Bone marrow biopsy
B) Ultrasound
Rationale: Ultrasound (especially Doppler ultrasound) is commonly used to detect deep vein thrombosis (DVT) and arterial blockages caused by thrombi/emboli.
A 65-year-old patient with atrial fibrillation suddenly develops weakness in the right arm, slurred speech, and facial droop. What is the most likely cause?
A) Pulmonary embolism
B) Hemorrhagic stroke
C) Embolic stroke
D) Myocardial infarction
C) Embolic stroke
Rationale: Patients with atrial fibrillation are at high risk of embolism due to stasis of blood in the atria, which can form clots that travel to the brain, causing an embolic stroke.
Which of the following is a preventative measure to reduce the risk of thrombus formation?
A) Bed rest and fluid restriction
B) Increased mobility and hydration
C) High-protein diet and corticosteroids
D) Avoiding compression devices
B) Increased mobility and hydration
Rationale: Preventing stasis is key in reducing thrombus formation. Mobility, hydration, antiembolism hosiery, and sequential compression devices help prevent venous stasis and clot formation.
A post-surgical patient has been on bed rest for 48 hours. The nurse notices unilateral leg swelling, warmth, and redness. What is the most likely diagnosis?
A) Peripheral artery disease (PAD)
B) Cellulitis
C) Deep vein thrombosis (DVT)
D) Gout
C) Deep vein thrombosis (DVT)
Rationale: Unilateral leg swelling, warmth, and redness are classic signs of DVT, a venous thrombus often associated with immobility and Virchow’s Triad.
A pulmonary embolism (PE) is most often caused by a thrombus originating from which location?
A) Coronary arteries
B) Deep veins of the legs
C) Carotid artery
D) Left ventricle
B) Deep veins of the legs
Rationale: Pulmonary embolisms (PEs) are most commonly caused by deep vein thrombosis (DVT) from the legs, which can dislodge, travel through the venous system, and block a pulmonary artery.
A patient with a femur fracture suddenly develops shortness of breath, chest pain, and tachycardia. What is the most likely diagnosis?
A) Pneumothorax
B) Pulmonary embolism
C) Myocardial infarction
D) Pulmonary edema
B) Pulmonary embolism
Rationale: Femur fractures increase the risk of fat embolism syndrome (FES) or thromboembolism, which can travel to the lungs, blocking circulation and causing a PE.
What is the most common surgical treatment for an embolus that is causing life-threatening complications?
A) Angioplasty
B) Coronary artery bypass graft (CABG)
C) Embolectomy
D) Stent placement
C) Embolectomy
Rationale: Embolectomy is the surgical removal of an embolus to restore blood flow and prevent tissue death.
A 72-year-old patient with a history of DVT is prescribed warfarin. What should the nurse monitor?
A) Troponin levels
B) Partial thromboplastin time (PTT)
C) International normalized ratio (INR)
D) D-dimer
C) International normalized ratio (INR)
Rationale: Warfarin therapy is monitored using INR, which should be kept between 2.0 – 3.0 to prevent clot formation while minimizing bleeding risk.
Which of the following patients is at highest risk for developing a thrombus?
A) A 25-year-old on oral contraceptives who smokes
B) A 35-year-old with seasonal allergies
C) A 50-year-old athlete with a balanced diet
D) A 60-year-old with well-controlled hypertension
A) A 25-year-old on oral contraceptives who smokes
Rationale: Oral contraceptives and smoking both increase the risk of hypercoagulability, making this patient high risk for thrombosis.
A patient is diagnosed with DVT and prescribed low-molecular-weight heparin (LMWH). What is the purpose of this medication?
A) To dissolve the existing clot
B) To break down fibrin deposits
C) To prevent further clot formation
D) To increase platelet aggregation
C) To prevent further clot formation
Rationale: Heparin and LMWH do not dissolve clots, but they prevent further clot formation and reduce embolization risk.
Which symptom is most concerning in a patient with a known thrombus?
A) Mild swelling in the affected limb
B) Sudden-onset shortness of breath
C) Localized pain in the limb
D) Low-grade fever
B) Sudden-onset shortness of breath
Rationale: Sudden shortness of breath may indicate a pulmonary embolism (PE), which is a medical emergency requiring immediate intervention.
