Test 2: Deep Vein Thrombosis (DVT) and Pulmonary Embolus (PE)

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12 Terms

1
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What are the three criteria in Virchow’s Triad?

  • Venous stasis – slow blood flow (immobility, surgery, heart failure)

  • Endothelial injury – vessel wall damage (trauma, IV lines)

  • Hypercoagulability – increased clotting tendency (cancer, pregnancy, estrogen, dehydration)

2
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How does Virchow’s Triad relate to the pathophysiology of thrombus formation?

Each factor contributes to clot development: sluggish flow, vessel injury, or thickened blood leads to platelet aggregation → fibrin formation → thrombus (clot) development → potential embolization.

3
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What are the clinical manifestations of a DVT?

  • Unilateral leg swelling or edema

  • Pain or tenderness (often in calf)

  • Warmth and redness over affected area

  • Dilated superficial veins

  • Positive Homans’ sign (pain on dorsiflexion — no longer used diagnostically)

4
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What are the nursing assessments for someone with suspected DVT?

  • Compare limb size and color bilaterally

  • Assess for warmth, tenderness, and edema

  • Check peripheral pulses

  • Monitor vital signs (watch for PE symptoms)

5
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What pharmacological interventions are used to treat DVT?

  • Anticoagulants: Heparin (acute), warfarin or DOACs (long-term)

  • Thrombolytics: Used in severe or life-threatening cases

  • Pain management: Analgesics as needed

6
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What non-pharmacological interventions are used for DVT?

  • Bed rest initially (to prevent embolization)

  • Elevate limb (to reduce swelling)

  • Compression stockings after acute phase

  • Hydration to reduce blood viscosity

  • Early ambulation post-prevention phase

7
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Why is a pulmonary embolus (PE) considered life-threatening?

The clot blocks blood flow in pulmonary arteries → impaired gas exchange → right heart strain → decreased oxygenation → possible cardiac arrest.

8
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Who is at risk for developing a PE?

  • Post-surgical or immobile patients

  • Those with DVT or history of clots

  • Pregnant or postpartum clients

  • Cancer patients

  • Those taking estrogen therapy

  • Smokers and those with obesity

9
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How can we prevent pulmonary embolus

  • Early ambulation post-op

  • Sequential compression devices (SCDs)

  • Leg elevation

  • Hydration

  • Prophylactic anticoagulants (e.g., heparin, enoxaparin)

10
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What is the classic triad of symptoms for pulmonary embolus (PE)?

  1. Dyspnea (sudden shortness of breath)

  2. Chest pain (pleuritic, sharp)

  3. Hemoptysis (coughing up blood)

Other signs: tachycardia, anxiety, low O₂ saturation, hypotension.

11
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What are nursing priorities for a suspected PE?

  • Elevate head of bed

  • Apply O₂ immediately

  • Stay with patient; reduce anxiety

  • Notify physician/RRT

  • Prepare for possible anticoagulant or thrombolytic therapy

  • Monitor vitals and SpO₂ continuously

12
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How are DVT and PE diagnosed?

  • DVT: Doppler ultrasound, D-dimer test

  • PE: CT pulmonary angiography, V/Q scan, ABGs (show low PaO₂)