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Nursing:
doi: 10.1097/01.NURSE.0000348410.96441.44
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What you need to know about venous thromboembolism

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For more than 81 additional continuing-education articles related to cardiovascular topics, go to NursingCenter.com/CE.

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INSTRUCTIONS What you need to know about venous thromboembolism

TEST INSTRUCTIONS

* To take the test online, go to our secure Web site at http://www.nursingcenter.com/ce/nursing.

* On the print form, record your answers in the test answer section of the CE enrollment form on page 28. Each question has only one correct answer. You may make copies of these forms.

* Complete the registration information and course evaluation. Mail the completed form and registration fee of $21.95 to: Lippincott Williams & Wilkins, CE Group, 2710 Yorktowne Blvd., Brick, NJ 08723. We will mail your certificate in 4 to 6 weeks. For faster service, include a fax number and we will fax your certificate within 2 business days of receiving your enrollment form.

* You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.

* Registration deadline is April 30, 2011.

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* Send two or more tests in any nursing journal published by Lippincott Williams & Wilkins together and deduct $0.95 from the price of each test.

* We also offer CE accounts for hospitals and other healthcare facilities on nursingcenter.com. Call 1-800-787-8985 for details.

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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of Nursing2009 journal, will award 2.3 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #FBN2454. Lippincott Williams & Wilkins home study activities are classified for Texas nursing continuing education requirements as Type 1. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.3 contact hours.

Your certificate is valid in all states.

What you need to know about venous thromboembolism

GENERAL PURPOSE To provide nurses with an overview of VTE. LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to: 1. Describe the pathophysiology of VTE. 2. Identify clinical manifestations of VTE. 3. List management strategies for patients with VTE.

1. Which blood vessel is occluded by a PE?

a. pulmonary artery

b. pulmonary vein

c. popliteal vein

d. femoral vein

2. When assessing for calf edema, measure the circumference of the patient's leg 4 inches

a. below the patella.

b. below the tibial tuberosity.

c. above the medial malleolus.

d. above the calcaneal tuberosity.

3. Signs of a lower extremity DVT include

a. tachypnea.

b. tachycardia.

c. unilateral leg edema.

d. hemoptysis.

4. Which d-dimer value is least likely to be associated with a DVT?

a. 450 ng/L

b. 550 ng/L

c. 750 ng/L

d. 900 ng/L

5. A duplex ultrasound is highly accurate for detecting proximal DVT in which veins?

a. popliteal and anterior tibial

b. femoral and posterior tibial

c. femoral and popliteal

d. peroneal and anterior tibial

6. Which test is considered the gold standard for detecting a DVT?

a. d-dimer

b. duplex ultrasound

c. V˙/Q˙ scan

d. contrast venography

7. Which diagnostic study is most useful in confirming a PE diagnosis?

a. chest X-ray

b. spiral computed tomography pulmonary angiography

c. ECG

d. ABGs

8. Which is a normal V˙/Q˙ value?

a. 0.5

b. 0.8

c. 1.0

d. 1.1

9. For low-risk general surgery patients, the recommended VTE prophylaxis is

a. aspirin.

b. warfarin.

c. LMWH.

d. early and aggressive ambulation.

10. Which drug is a fibrinolytic?

a. heparin

b. warfarin

c. streptokinase

d. protamine sulfate

11. Initial management for a hemodynamically stable patient with a PE and no bleeding risk will most likely include

a. pulmonary embolectomy.

b. IVC filter placement.

c. elastic compression sleeves.

d. fibrinolytic therapy.

12. The goal of warfarin therapy for DVT is an INR range of

a. 0.5 to 1.

b. 1.3 to 1.5.

c. 2 to 3.

d. 3.5 to 5.

13. The antidote for excessive heparin anticoagulation is

a. protein C.

b. vitamin K.

c. urokinase.

d. protamine sulfate.

14. Tell patients taking warfarin therapy to

a. avoid leafy green vegetables.

b. increase intake of leafy green vegetables.

c. eat a consistent, limited amount of foods high in vitamin K.

d. eat a consistent, limited amount of foods high in vitamin C.

15. Which substances may decrease warfarin's anticoagulation effect?

a. ginseng

b. ginkgo biloba

c. chamomile

d. St. John's wort

16. Air travelers at high risk for VTE should wear graduated compression stockings providing how much pressure at the ankles?

a. 5 to 10 mm Hg

b. 15 to 30 mm Hg

c. 35 to 45 mm Hg

d. 50 to 60 mm Hg

17. LMWH is indicated for patients at

a. low VTE risk without bleeding risk.

b. low-to-moderate VTE risk with bleeding risk.

c. moderate-to-high VTE risk with bleeding risk.

d. moderate-to-high VTE risk without bleeding risk.

18. Which scoring system specifically measures a patient's DVT risk?

a. Wells clinical prediction rule

b. Bloomsbury

c. Cohen

d. Ramsay

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