A nurse is educating a client who is at high risk for developing deep vein thrombosis.

The nurse should instruct the client to avoid which of the following activities?

The correct answer is choice A, B and E.A D-dimer test is a blood test that measures D-dimer, which is a protein fragment that your body makes when a blood clot dissolves in your body.A positive or elevated D-dimer test result may indicate that you have a blood clotting condition, such as:

• Deep vein thrombosis (DVT): a blood clot that develops in a vein deep in your body, usually in the legs.

• Pulmonary embolism (PE): a blockage in an artery in the lung caused by a blood clot that travels from another part of the body, such as the leg.

• Disseminated intravascular coagulation (DIC): a condition that prevents the blood from clotting normally and causes excessive bleeding or clotting throughout the body.

Choice C and D are wrong because:

• Myocardial infarction (MI): a heart attack caused by a blockage in one of the coronary arteries that supply blood to the heart muscle.A D-dimer test is not used to diagnose MI because other blood tests, such as troponin and CK-MB, are more specific and sensitive for detecting heart muscle damage.

• Stroke: a brain attack caused by a blockage or rupture of a blood vessel in the brain.A D-dimer test is not used to diagnose stroke because other imaging tests, such as CT scan or MRI, are more accurate and reliable for detecting brain damage.

The normal range of D-dimer levels varies depending on the laboratory and the method used, but it is usually less than 0.5 mg/L or 500 ng/mL.However, the normal range may also depend on other factors, such as age, pregnancy, inflammation, infection, trauma, surgery or cancer.

Therefore, a D-dimer test result should always be interpreted in the context of the clinical situation and other test results.

CT pulmonary angiography (CTPA) is the new reference standard for the diagnosis of pulmonary embolism (PE).It is a non-invasive imaging test that uses contrast dye and X-rays to visualize the pulmonary arteries and detect blood clots.

Choice A is wrong because compression ultrasound is used to diagnose deep vein thrombosis (DVT), not PE.However, if a DVT is found in a patient with clinical suspicion for PE, the diagnosis of PE can be accepted without further testing.

Choice C is wrong because ventilation-perfusion scan is an alternative test for PE when CTPA is contraindicated or unavailable.It uses radioactive tracers to measure the airflow and blood flow in the lungs and detect any mismatch that suggests a PE.

Choice D is wrong because chest X-ray cannot diagnose PE directly.

It can only show nonspecific signs of PE such as atelectasis, pleural effusion, or elevated hemidiaphragm.It can also help rule out other causes of chest pain or dyspnea.