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Clinical Manifestations and Assessment

- The signs and symptoms of DVT depend on the location and size of the clot. Some patients may have no symptoms at all.

- The common signs and symptoms include:

  • Limb pain: a feeling of fullness or heaviness in the affected leg after standing or walking. The pain may be worse when flexing the foot or extending the knee.
  • Limb swelling: a sudden onset of edema in the affected leg that may extend to the thigh or groin. The leg may appear larger than the other leg.
  • Limb warmth: an increased temperature in the affected leg compared to the other leg.
  • Limb redness: a change in skin color in the affected leg that may be bluish or purple.
  • Limb induration: a hardening or thickening of the skin or subcutaneous tissue over the affected vein.
  • Shortness of breath and chest pain: these are signs of PE and require immediate medical attention.

- The assessment of a patient with suspected DVT includes:

  • A detailed medical history to identify the risk factors and symptoms of DVT.
  • A physical examination is to inspect and palpate the affected leg for signs of DVT. The examiner should also check for signs of PE, such as tachypnea, tachycardia, hypoxia, or hemoptysis.
  • A comparison of the circumference of both legs at different levels to detect any difference in size.
  • A measurement of the calf muscle squeeze test (Homan's sign) to elicit pain in the calf when squeezing it. However, this test is not reliable and may be positive in other conditions or negative in some cases of DVT.

Questions on Clinical Manifestations and Assessment

Correct Answer is B

Explanation

This choice is correct. Staying hydrated and drinking plenty of water can help prevent DVT by maintaining adequate blood volume and circulation. Dehydration can increase the risk of blood clot formation.

Correct Answer is B

Explanation

This choice is incorrect because performing a capillary refill test is not specific to DVT assessment. Capillary refill is a measure of peripheral perfusion and may be useful in assessing overall circulatory status, but it does not directly confirm the presence of DVT.

Correct Answer is B

Explanation

This choice is incorrect because while administering anticoagulant therapy is a common treatment for DVT, it is a specific intervention rather than the primary goal. Anticoagulants help prevent the clot from growing and reduce the risk of embolism.

Correct Answer is A

Explanation

This choice is incorrect because providing a soft mattress for the client's bed does not directly prevent DVT. The focus should be on encouraging movement and mobility to prevent DVT in clients at risk.

Correct Answer is A

Explanation

This choice is incorrect because clients on warfarin should be cautious about taking over-the-counter pain medications, especially nonsteroidal anti-inflammatory drugs (NSAIDs), which can increase the risk of bleeding. Clients should consult their healthcare provider before taking any new medications while on warfarin.Questions

Correct Answer is C

Explanation

This choice is incorrect because while the client may have difficulty controlling a sedentary lifestyle, it is still considered a modifiable risk factor for DVT. Engaging in regular physical activity can help reduce the risk of blood clot formation.

Correct Answer is C

Explanation

This choice is incorrect because the use of medications for diabetes does not directly relate to DVT risk. While some medications may influence blood clotting, diabetes itself is not a primary risk factor for DVT.

Correct Answer is A

Explanation

This choice is incorrect because a sedentary lifestyle is a modifiable risk factor for DVT. Clients can engage in regular physical activity to reduce their risk.

Correct Answer is D

Explanation

This choice is correct. Deep vein thrombosis (DVT) is primarily caused by the formation of blood clots within the veins, typically in the lower extremities. These clots can obstruct blood flow and may lead to serious complications if not treated promptly.

Correct Answer is D

Explanation

This choice is correct. Estrogen-based hormone replacement therapy and oral contraceptives can increase the risk of DVT due to their effect on blood coagulation. Estrogen can increase the production of certain clotting factors, raising the risk of blood clot formation in the veins. It is essential for healthcare providers to weigh the benefits and risks when prescribing hormonal therapy to clients.Questions

Correct Answer is B

Explanation

This choice is incorrect because weak pedal pulses and cool extremities are not typically associated with DVT. These findings suggest potential arterial insufficiency rather than venous thrombosis.

Correct Answer is B

Explanation

This choice is incorrect because performing a capillary refill test is primarily used to assess peripheral perfusion and is not specific to DVT assessment.

Correct Answer is C

Explanation

This choice is incorrect because abdominal pain and distension are not typical signs of a pulmonary embolism. Abdominal pain may be related to other causes, such as gastrointestinal issues.

Correct Answer is B

Explanation

This choice is incorrect because a chest X-ray is not used to confirm DVT. It is helpful in assessing the lungs and heart, particularly for detecting potential complications of DVT like a pulmonary embolism, but it does not directly diagnose DVT.

Correct Answer is B

Explanation

This choice is incorrect because evaluating the client's respiratory rate and pattern is not the priority action for monitoring the response to anticoagulant therapy. Respiratory assessment is vital in detecting potential complications like a pulmonary embolism but does not directly assess the client's anticoagulation status.Questions

This choice is correct. Contrast venography involves injecting contrast dye into the veins and taking X-ray images to visualize the blood flow and detect any clots. It is considered the gold standard for diagnosing DVT, as it provides direct visualization of the clot and the extent of its involvemen

This choice is correct. The Wells score assessment is a validated tool used to estimate the likelihood of DVT based on clinical criteria and risk factors. It is commonly used as the first step in the diagnostic workup to determine if further testing, such as venous Doppler ultrasound or D-dimer bloo

This choice is incorrect because the Wells score assessment is not a diagnostic test but a scoring system to estimate the likelihood of DVT. It does not provide rapid results to rule out DVT directly.

This choice is incorrect because contrast dye is not typically used in a venous Doppler ultrasound. Contrast venography may involve the use of contrast dye, but not Doppler ultrasound.Questions

This choice is incorrect because while anticoagulants can improve blood flow by preventing clot formation, they do not directly "improve" blood flow to the affected limb.

This choice is correct. Compression stockings exert pressure on the legs, assisting in venous return and preventing blood from pooling and clot formation. They are used as a preventive measure for individuals at risk of DVT or those diagnosed with DVT to reduce the risk of complications and recurren

This choice is correct. Monitoring the client's activated partial thromboplastin time (aPTT) is the priority action when administering intravenous heparin. The aPTT reflects the client's response to heparin and helps adjust the dosage to achieve the desired therapeutic effect while minimizing the ri

This choice is incorrect because discontinuing warfarin without medical guidance can be dangerous. Warfarin is typically prescribed for a specific duration, and its cessation should be guided by the healthcare provider based on the client's individual condition and risk factors.

This choice is incorrect because elevating the legs while resting is a recommended measure to improve blood flow and reduce edema, which can be beneficial. However, wearing graduated compression stockings is a more specific preventive measure for DVT.

This choice is incorrect because taking over-the-counter pain medications for leg discomfort does not prevent DVT. While pain management may be necessary for symptomatic relief, it does not address the underlying risk factors for DVT.

This choice is incorrect because taking prescribed anticoagulant medication before boarding a flight is not a recommended preventive measure for all clients. The decision to take anticoagulant medication before a flight should be based on the client's individual risk factors and medical history.

This choice is correct. The client should continue taking prescribed anticoagulant medication as directed by their healthcare provider. Anticoagulant therapy is often prescribed for a specific duration to prevent clot formation and reduce the risk of complications in clients with DVT.

This choice is incorrect because mild fatigue and generalized body aches are non-specific symptoms and may not be directly related to DVT. While it is essential to report any new or concerning symptoms, redness and warmth in the affected leg are more indicative of potential complications related to

<p>This choice is correct. Venous Doppler ultrasound is a non-invasive imaging test used to assess blood flow in the veins and detect clots in the deep veins of the legs. It is readily available, safe, and does not involve the use of contrast dye or radiation.</p>
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