Clinical Manifestations of DVT
Clinical Manifestations of DVT ( 5 Questions)
A nurse is preparing to discharge a client who has DVT and is prescribed low molecular weight heparin (LMWH).
Which of the following information should the nurse include in the discharge teaching?
How to administer LMWH subcutaneously. LMWH is a class of anticoagulant medications that are used to prevent and treat blood clots, such as DVT and PE LMWH can be given subcutaneously and does not require frequent blood tests to monitor coagulation, unlike unfractionated heparin Therefore, the nurse should teach the client how to inject LMWH into the fatty tissue under the skin, usually in the abdomen or thigh, using a prefilled syringe
This statement is wrong because LMWH has more predictable pharmacokinetics and anticoagulant effect than unfractionated heparin, and does not require routine monitoring of APTT or anti-factor Xa levels However, some patients may need monitoring in special situations, such as extremes of weight, renal impairment, or pregnancy
This statement is wrong because HIT is a rare but serious complication of heparin therapy that causes a drop in platelet count and an increased risk of thrombosis HIT is more common with unfractionated heparin than with LMWH, but it can still occur with LMWH in some cases Therefore, the nurse should inform the client about the signs and symptoms of HIT, such as fever, chills, rash, bleeding, bruising, or new or worsening clots, and advise them to seek medical attention if they occur
This statement is wrong because there is no specific antidote for LMWH in case of overdose or bleeding complications Unlike unfractionated heparin, which can be reversed with protamine sulfate, LMWH has only partial reversal with protamine sulfate and may require other measures such as transfusion of blood products or use of recombinant factor VIIa Therefore, the nurse should instruct the client to follow the prescribed dose and schedule of LMWH and to report any signs of bleeding or overdose, such as nosebleeds, gum bleeding, blood in urine or stool, or excessive bruising
The correct answer is A. How to administer LMWH subcutaneously. LMWH is a class of anticoagulant medications that are used to prevent and treat blood clots, such as DVT and PE LMWH can be given subcutaneously and does not require frequent blood tests to monitor coagulation, unlike unfractionated heparin Therefore, the nurse should teach the client how to inject LMWH into the fatty tissue under the skin, usually in the abdomen or thigh, using a prefilled syringe.
B. The need for frequent blood tests to monitor coagulation. This statement is wrong because LMWH has more predictable pharmacokinetics and anticoagulant effect than unfractionated heparin, and does not require routine monitoring of APTT or anti-factor Xa levels However, some patients may need monitoring in special situations, such as extremes of weight, renal impairment, or pregnancy.
C. The signs and symptoms of heparin-induced thrombocytopenia (HIT). This statement is wrong because HIT is a rare but serious complication of heparin therapy that causes a drop in platelet count and an increased risk of thrombosis HIT is more common with unfractionated heparin than with LMWH, but it can still occur with LMWH in some cases Therefore, the nurse should inform the client about the signs and symptoms of HIT, such as fever, chills, rash, bleeding, bruising, or new or worsening clots, and advise them to seek medical attention if they occur.
D. The antidote for LMWH in case of overdose. This statement is wrong because there is no specific antidote for LMWH in case of overdose or bleeding complications Unlike unfractionated heparin, which can be reversed with protamine sulfate, LMWH has only partial reversal with protamine sulfate and may require other measures such as transfusion of blood products or use of recombinant factor VIIa Therefore, the nurse should instruct the client to follow the prescribed dose and schedule of LMWH and to report any signs of bleeding or overdose, such as nosebleeds, gum bleeding, blood in urine or stool, or excessive bruising.