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New Reading Part A 2
New Reading Part A 2
New Reading Part A 2
Text A
Deep vein thrombosis occurs when a blood clot (thrombus) forms in one or more of the deep
veins in the body, usually in the legs.
Deep vein thrombosis can cause leg pain or swelling, but may occur without any symptoms.
Deep vein thrombosis is a serious condition because blood clots in the veins can break loose,
travel through the bloodstream, and obstruct the lungs, blocking blood flow.
Text B
Clinical Manifestations
A major problem associated with recognizing DVT is that the signs and symptoms are
nonspecific.
Edema: With obstruction of the deep veins comes edema and swelling of the extremity because
the outflow of venous blood is inhibited
Tenderness:Tenderness, which usually occurs later, is produced by inflammation of the vein wall
and can be detected by gently palpating the affected extremity.
Pulmonary embolus:In some cases, signs and symptoms of a pulmonary embolus are the first
indication of DVT
Medical Management
The objectives for treatment of DVT are to prevent thrombus from growing and fragmenting,
recurrent thromboemboli, and post thrombotic syndrome.
Vena cava filter: A vena cava filter may be placed at the time of thrombectomy; this filter traps
late emboli and prevents pulmonary emboli.
Text C
Heparin (Rx)
Drug education : The nurse should teach about the prescribed anticoagulant, its purpose, and the
need to take the correct amount at the specific times prescribed.
Blood tests: The patient should be aware that periodic blood tests are necessary to determine if a
change in medication or dosage is required.
Avoid alcohol : A person who refuses to discontinue the use of alcohol should not receive
anticoagulants because chronic alcohol intake decreases their effectiveness.
Activity: Explain the importance of elevating the legs and exercising adequately.
Text D
Verbalize understanding of condition, therapy, regimen, side effects of medications, and when to
contact the healthcare provider.
Maintain position of function and skin integrity as evidenced by absence of contractures, foot
drop, decubitus, and so forth.
Maintain or increase strength and function of affected and/or compensatory body part.
Nursing Interventions
The major nursing interventions that the nurse should observe are:
Provide comfort; Elevation of the affected extremity, graduated compression stockings, warm
application, and ambulation are adjuncts to the therapy that can remove or reduce discomfort.
Compression therapy: Graduated compression stockings reduce the caliber of the superficial
veins in the leg and increase flow in the deep veins; external compression devices and wraps are
short stretch elastic wraps that are applied from the toes to the knees in a 50% spiral overlap;
intermittent pneumatic compression devices increase blood velocity beyond that produced by the
stockings.
Positioning and exercise: When patient is on bed rest, the feet and lower legs should be elevated
periodically above the level of the heart, and active and passive leg exercises should be
performed to increase venous flow.
Part A
TIME: 15 minutes
● For each question, 1-20, look through the texts, A-d, to find the relevant information.
Questions 8-14
Answer each questions, 8-4, with a word or short phrase from one of the texts. Each answer may
include words, number or the both. Your answers should be correctly spelled.
Questions 15-20
Complete each of the sentences, 15- 20, with a word or short phrase from one of the texts. Each
answer may include words, number or both. Your answers should be correctly spelled
15. A major problem is associated with recognizing DVT is that the signs and symptoms are
………………………………….
16. Tenderness which usually occurs later is produced by……………….of the vein wall
17. In some cases, signs and symptoms of a …………are the first indication.
18. First PPT check is ……………… hours after starting infusion.
19. 5000 units IV bolus, then continued infusion of ………units/hr.
20. The patient should be aware of periodic blood tests which are necessary to determine if a
change in ………………… or dosage is required.
Answer key
1 B
2 B
3 C
4 A
5 D
6 C
7 D
8 SC/IV
9 Legs
10 Thrombectomy
11 Endovascular management
12 Phlegmasiaceruleadolens
13 Tenderness
14 Venous thromboembolism
15 Nonspecific
16 Inflammation
17 Pulmonary embolus
18 6
19 1300
20 medication