Deep Vein Thrombosis (16 Questions)

1. M. Jacques Tremblay, 68 years old, is recovering from a total hip replacement surgery performed 3 days ago. He calls the nurse complaining of a "cramping" pain in his right calf. Upon assessment, the nurse notes that the right calf circumference is 3 cm larger than the left, and the skin is warm and slightly red.

Question:
What does the nurse suspect is occurring? *
2. Mme. Marie-Eve Gagnon, 45 years old, is hospitalized for pneumonia and is on bed rest with bathroom privileges. She has a BMI of 35. The nurse is planning care to prevent venous thromboembolism (VTE).

Question:
Which nursing intervention is contraindicated (should be avoided) for DVT prevention? *
3. M. Luc Dubois, 58 years old, is receiving a continuous IV infusion of Unfractionated Heparin for a confirmed DVT in the left femoral vein. The protocol indicates a therapeutic range of 46–70 seconds for the aPTT. The laboratory calls with the latest aPTT result: 110 seconds.

Question:
What is the nurse’s priority action? *
4. Mme. Claire Fortin, 72 years old, has been on IV Heparin for 3 days for a DVT. The physician writes an order to start Warfarin (Coumadin) 5 mg PO daily. Mme. Fortin asks, "Why am I taking two blood thinners? Isn't that dangerous?"

Question:
What is the best explanation by the nurse? *
5. M. Antoine Cote, 60 years old, is diagnosed with an acute DVT in the right calf. He is started on anticoagulation therapy. His wife asks, "My husband’s leg hurts. Should I massage it to help the circulation?"

Question:
What is the most critical teaching point the nurse must provide? *
6. Mme. Isabelle Poirier, 50 years old, is being treated for DVT. She suddenly rings the call bell. When the nurse arrives, Mme. Poirier is clutching her chest, gasping for air, and appears terrified. Her heart rate is 120 bpm, and SpO2 is 88%.

Question:
What is the nurse’s priority intervention? *
7. M. Étienne Bouchard, 65 years old, is being discharged on Warfarin (Coumadin) for 6 months following a DVT. The nurse is providing dietary teaching regarding Vitamin K.

Question:
Which statement by M. Bouchard indicates a correct understanding of the teaching? *
8. Mme. Valérie Lavoie, 44 years old, has been on Heparin therapy for 5 days. The nurse reviews her morning labs.

Day 1 Platelet count: 250,000/mm³
Day 5 Platelet count: 90,000/mm³

Question:
What condition should the nurse suspect, and what is the required action? *
9. Mme. Geneviève St-Laurent, 30 years old, presents to the clinic with left calf swelling and pain. She has no history of trauma. During the health history interview, the nurse identifies risk factors for DVT (Virchow’s Triad).

Question:
Which combination of factors places this patient at the highest risk for DVT? *
10. M. Patrick Roy, 75 years old, visits the anticoagulation clinic for his routine INR check. He is taking Warfarin for a recurrent DVT. His INR result is 2.5.

Question:
What is the appropriate nursing action based on this result? *
11. M. Roch Voisine, 55 years old, is being treated for a DVT. The physician orders Enoxaparin (Lovenox) subcutaneous injections instead of an IV Unfractionated Heparin drip. M. Voisine asks, "Why is this injection better than the IV drip my father had years ago?"

Question:
What is the most accurate information the nurse can provide regarding the advantage of Enoxaparin (Low-Molecular-Weight Heparin)? *
12. M. Félix Leclerc, 70 years old, has been stable on Warfarin (Coumadin) for 3 months with an INR of 2.5. He tells the nurse, "I decided to get healthy. For the last week, I have been drinking 3 cups of Matcha Green Tea and eating a large bowl of Broccoli for lunch every day."

Question:
Based on this dietary change, what clinical change should the nurse anticipate? *
13. Mme. Julie Payette, 62 years old, is newly prescribed Warfarin (Coumadin). During the nutritional assessment, she mentions, "I always start my day with a large glass of freshly squeezed grapefruit juice."

Question:
What is the priority nursing instruction? *
14. M. Jean Béliveau, 78 years old, is being discharged on long-term anticoagulant therapy. The nurse is reviewing "Bleeding Precautions" to prevent injury during Activities of Daily Living (ADLs).

Question:
Which statement by M. Béliveau indicates that the teaching has been effective? *
15. The nurse is teaching Mme. Karine Vanasse, 35 years old, how to self-administer Enoxaparin (Lovenox) at home for DVT prophylaxis. The nurse observes Mme. Vanasse preparing the pre-filled syringe. Mme. Vanasse says, "I see a little air bubble in the syringe. I should push that out before I inject, right?"

Question:
What is the correct nursing response? *
16. M. Serge Bouchard, 48 years old, is a long-haul truck driver who frequently travels from Montréal to Vancouver (a drive taking several days). He was treated for a DVT two years ago. He visits the clinic for a check-up before his next trip. He asks the nurse, "I have to sit in the driver's seat for 10 to 12 hours a day to make my delivery times. How can I stop the clot from coming back?"

Question:
What is the most appropriate teaching the nurse should provide regarding his travel routine? *