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OR Nurse:
doi: 10.1097/01.ORN.0000419665.37676.85
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Preventing deep vein thrombosis in perioperative patients

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INSTRUCTIONS Preventing deep vein thrombosis in perioperative patients


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Preventing deep vein thrombosis in perioperative patients

GENERAL PURPOSE: To provide nurses with an overview of DVT in surgical patients. LEARNING OBJECTIVES: After reading the preceding article and taking this test, you should be able to: 1. Describe the pathophysiology and risk factors for DVT. 2. Identify perioperative nursing assessments and interventions related to DVT development in surgical patients.

1. Which isn't included in Virchow triad?

a. vessel constriction

b. endothelial or vessel wall injury

c. hypercoagulability

d. venous stasis

2. Venous stasis leads to

a. platelet and thrombin aggregation.

b. hypocoagulation.

c. incompetent venous valves.

d. vessel necrosis.

3. Which patient has the most risk factors for DVT?

a. 28-year-old man having an open cholecystectomy

b. 32-year-old pregnant woman having a caesarean section

c. 52-year-old obese woman having a THA

d. 66-year-old woman having a vaginal hysterectomy

4. Hypercoagulability factors contributing to DVT formation include all except

a. malignancies.

b. dehydration.

c. spinal cord injury.

d. septicemia.

5. Endothelial wall damage can result from

a. dehydration.

b. fever.

c. polycythemia.

d. diabetes.

6. Thrombi can increase in size through which mechanism?

a. engorgement of collected blood cells

b. increasing numbers of blood cells and fibrin

c. creation of a fibrin mesh across the lumen of the blood vessel

d. swelling of venous valves

7. Which of the following are signs and symptoms of a DVT?

a. positive Homans sign and pale extremity

b. diminished pedal pulses and cool extremity

c. warm and tender extremity

d. fever spikes and bilateral edema

8. Classic manifestations of PE are

a. productive cough, wheezing, and fever.

b. anxiety, pleuritic chest pain, and dyspnea.

c. chest pain, headache, and pleural friction rub.

d. heaviness in chest, nonproductive cough, and crackles.

9. In a patient undergoing a THA, antigens that may cause clotting are released during

a. reaming of the bone.

b. the initial incision.

c. prolonged immobility.

d. use of cement.

10. Which type of surgery carries the lowest risk of DVT?

a. general, open procedures

b. obstetric

c. neurologic

d. genitourologic

11. A score of 4 on the Wells criteria indicates a

a. low risk of VTE.

b. low risk of DVT.

c. moderate risk of DVT.

d. high risk of DVT.

12. Advise patients to refrain from nicotine use preoperatively for at least

a. 1 day.

b. 2 to 3 days.

c. 4 to 5 days.

d. 7 days.

13. Which of the following is part of the A,B,C,D,E mnemonic for assessing DVT risk?

a. activity level

b. blood cells (red and white)

c. diabetes

d. circumference of leg

14. Preoperatively, tell your patient that SCDs

a. will be applied once the patient is back in the inpatient room.

b. will be applied before anesthesia induction.

c. will prohibit ambulation for 24 hours.

d. take the place of foot and leg exercises.

15. Which of the following was FDA approved in 2011 to reduce VTE risk following hip or knee replacement surgery?

a. heparin

b. corticosteroids

c. rivaroxaban

d. warfarin

16. In the OR, nurses can minimize DVT risk by

a. using extra padding on pressure points.

b. ensuring that the straps are secure and tight.

c. keeping the patient's extremities below the level of the OR table.

d. asking the patient to perform ankle rotations.

17. The presence of DVT in the lower leg is assessed by comparing the patient's legs for all of the following except

a. circumference.

b. temperature.

c. pain.

d. skin turgor.

18. If indicated, which postoperative intervention can help to minimize DVT risk?

a. delay ambulation for 24 hours

b. elevate the foot of the bed

c. place pillows under the patient's knees

d. lightweight blankets to keep the patient's legs warm

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