Management of Postpartum Patients with DVT and PE
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a postpartum client who has a deep vein thrombosis (DVT) in her right leg.
Which of the following actions should the nurse take?
Explanation
Elevate the affected leg above the level of the heart.This helps to reduce swelling and pain by improving venous blood flow and preventing stasis.
Choice A is wrong because applying a cold compress to the affected area can cause vasoconstriction and worsen blood flow.It can also increase the risk of skin damage and infection.
Choice B is wrong because massaging the affected leg gently can dislodge the thrombus and cause a pulmonary embolism, which is a life-threatening complication of DVT.
Choice D is wrong because removing the antiembolism stockings periodically can increase the risk of thrombus formation and extension.Antiembolism stockings provide graduated compression that improves venous return and prevents edema.
Normal ranges for D-dimer, a marker of fibrin degradation and thrombosis, are less than 0.5 mcg/mL or 500 ng/mL.Elevated levels indicate a high probability of DVT or PE.
A nurse is teaching a postpartum client who is at high risk for developing a pulmonary embolism (PE) due to a history of thromboembolism.
Which of the following instructions should the nurse include in the teaching?
Explanation
All of the above.
The nurse should include all of these instructions in the teaching to prevent pulmonary embolism (PE) in a postpartum client who is at high risk due to a history of thromboembolism.
Choice A is correct because crossing the legs can impair venous return and increase the risk of deep vein thrombosis (DVT), which can lead to PE.
Choice B is correct because drinking enough fluids can prevent dehydration and blood viscosity, which are risk factors for DVT and PE.
Choice C is correct because chest pain and shortness of breath are common signs of PE and should be reported immediately for prompt diagnosis and treatment.
Normal ranges for fluid intake are about 2 to 3 liters per day for healthy adults, but may vary depending on individual factors such as activity level, climate, and medical conditions.Normal ranges for leg crossing are not well defined, but it is generally advised to avoid prolonged periods of sitting or lying down with crossed legs.
A nurse is reviewing the laboratory results of a postpartum client who has idiopathic thrombocytopenic purpura (ITP).
Which of the following findings should the nurse expect?
Explanation
Decreased platelet count.This is because idiopathic thrombocytopenic purpura (ITP) is a disorder that causes the immune system to destroy the platelets, which are blood cells that help control bleeding.
Therefore, a person with ITP will have a low number of platelets in their blood.
Increased prothrombin time (PT) is wrong because PT measures how long it takes for the blood to clot.
A high PT means that the blood clots too slowly, which can be caused by liver disease, vitamin K deficiency, or blood-thinning medications.ITP does not affect the PT.
Decreased fibrinogen level is wrong because fibrinogen is a protein that helps form blood clots.
A low fibrinogen level can be caused by excessive bleeding, liver disease, or inherited disorders.ITP does not affect the fibrinogen level.
Increased partial thromboplastin time (PTT) is wrong because PTT measures how long it takes for the blood to clot.
A high PTT means that the blood clots too slowly, which can be caused by hemophilia, lupus, or blood-thinning medications.ITP does not affect the PTT.
Normal ranges for platelet count are 150,000 to 450,000 per microliter of blood.Normal ranges for PT are 11 to 13.5 seconds.Normal ranges for fibrinogen are 200 to 400 milligrams per deciliter of blood.Normal ranges for PTT are 25 to 35 seconds.
A nurse is administering heparin IV to a postpartum client who has a pulmonary embolism (PE).
Which of the following assessments should the nurse monitor to evaluate the effectiveness of the therapy?
Explanation
Activated partial thromboplastin time (aPTT) is a test that measures how long it takes for the blood to clot.
Heparin is a drug that prevents blood clots by inhibiting certain clotting factors.The effectiveness of heparin therapy is monitored by measuring the aPTT, which should be 1.5 to 2.5 times the normal value.
If the aPTT is too low, it means that heparin is not working well and the risk of clotting is high.
If the aPTT is too high, it means that heparin is working too well and the risk of bleeding is high.
Choice A is wrong because haemoglobin and hematocrit levels are not affected by heparin therapy.
They measure the amount and concentration of red blood cells in the blood, which are not involved in clotting.
Choice C is wrong because the international normalized ratio (INR) is a test that measures how long it takes for the blood to clot when taking another anticoagulant drug called warfarin.
Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors.The effectiveness of warfarin therapy is monitored by measuring the INR, which should be 2 to 3 for most conditions.
Heparin does not affect the INR.
Choice D is wrong because platelet count is not affected by heparin therapy.
Platelets are small cell fragments that help form clots by sticking together and activating clotting factors.
Heparin does not affect the number of platelets in the blood, but it reduces their ability to aggregate and activate clotting factors.
A nurse is providing discharge teaching to a postpartum client who will be taking warfarin for 3 months following a deep vein thrombosis (DVT).
Which of the following statements by the client indicates an understanding of the teaching
Explanation
“I will have my blood tested once a week to check my medication level.” Warfarin is an anticoagulant that prevents blood clots from forming or growing larger.
It works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver.
The effect of warfarin varies from person to person and can be influenced by many factors, such as diet, other medications, and health conditions.
Therefore, it is important to monitor the blood level of warfarin regularly using a test called the international normalized ratio (INR), which measures how long it takes for the blood to clot.
The INR should be within a certain range, usually between 2 and 3, to prevent bleeding or clotting complications.
The client should have their INR checked at least once a week and adjust their warfarin dose accordingly.
Choice A is wrong because using a soft-bristled toothbrush is not enough to prevent bleeding gums.
Warfarin can increase the risk of bleeding from any injury or trauma, such as brushing the teeth, shaving, or cutting the skin.
The client should avoid activities that can cause bleeding and report any signs of bleeding, such as bruising, nosebleeds, blood in the urine or stool, or heavy menstrual bleeding.
Choice B is wrong because eating more green leafy vegetables can interfere with the effect of warfarin.
Green leafy vegetables are rich in vitamin K, which is needed for the production of clotting factors.
Eating more vitamin K can reduce the effectiveness of warfarin and increase the risk of clotting.
The client should maintain a consistent intake of vitamin K and avoid sudden changes in their diet.
Choice C is wrong because taking ibuprofen can increase the risk of bleeding.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can inhibit platelet function and cause stomach ulcers.
Both of these effects can worsen the bleeding tendency of warfarin.
The client should avoid NSAIDs and use other pain relievers, such as acetaminophen, if needed.
Sign Up or Login to view all the 5 Questions on this Exam
Join over 100,000+ nursing students using Nursingprepexams’s science-backend flashcards, practice tests and expert solutions to improve their grades and reach their goals.
Sign Up Now
