A nurse is providing education to a client with deep vein thrombosis (DVT) about potential complications. Which symptom should the nurse instruct the client to report immediately?

Mild leg swelling after prolonged standing.

Redness and warmth at the site of the affected leg.

Occasional cramping in the unaffected leg.

Mild fatigue and generalized body aches.

Answer and Explanation

The Correct Answer is B

A) This choice is incorrect because mild leg swelling after prolonged standing may be expected, especially in clients with a history of DVT. It is not a critical symptom to report immediately.

B) This choice is correct. Redness and warmth at the site of the affected leg could indicate an inflammatory response or progression of the clot. These signs may be indicative of a potential complication, such as an infection or extension of the clot, and should be reported immediately for further evaluation and intervention.

C) This choice is incorrect because occasional cramping in the unaffected leg may not be directly related to the DVT. While any changes in leg symptoms should be reported to the healthcare provider, this symptom is less urgent than redness and warmth in the affected leg.

D) This choice is incorrect because mild fatigue and generalized body aches are non-specific symptoms and may not be directly related to DVT. While it is essential to report any new or concerning symptoms, redness and warmth in the affected leg are more indicative of potential complications related to DVT.

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Correct Answer is C

Explanation

A) This choice is incorrect because a family history of high cholesterol is not directly related to DVT risk. While high cholesterol may contribute to other cardiovascular conditions, it is not a primary risk factor for DVT.

B) This choice is incorrect because a history of asthma is not a direct risk factor for DVT. Asthma is a respiratory condition and is not significantly associated with blood clot formation.

C) This choice is correct. Prolonged immobility during long flights, especially in cramped spaces, is a known risk factor for DVT. This condition is often referred to as "economy class syndrome" due to its association with long-haul flights in tight seating.

D) This choice is incorrect because the use of medications for diabetes does not directly relate to DVT risk. While some medications may influence blood clotting, diabetes itself is not a primary risk factor for DVT.

A. Monitoring the client's prothrombin time (PT) and international normalized ratio (INR). B. Assessing the client's liver function regularly. C. Administering heparin via a central venous catheter. D. Monitoring the client's activated partial thromboplastin time (aPTT).

Correct Answer is D

Explanation

A) This choice is incorrect because monitoring prothrombin time (PT) and international normalized ratio (INR) is more relevant to monitoring oral anticoagulant therapy (e.g., warfarin) and not intravenous heparin therapy.

B) This choice is incorrect because while liver function tests may be important for some medications, they are not the priority for clients on intravenous heparin therapy. Heparin is primarily eliminated by the kidneys.

C) This choice is incorrect because while administering heparin via a central venous catheter is possible, it is not the priority action for safe administration. Monitoring the client's response to heparin therapy is more important.

D) This choice is correct. Monitoring the client's activated partial thromboplastin time (aPTT) is the priority action when administering intravenous heparin. The aPTT reflects the client's response to heparin and helps adjust the dosage to achieve the desired therapeutic effect while minimizing the risk of bleeding.

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A nurse is providing education to a client with deep vein thrombosis (DVT) about potential complications. Which symptom should the nurse instruct the client to report immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is admitted to the hospital with a suspected deep vein thrombosis (DVT). Which question should the nurse ask during the health history to identify potential risk factors for DVT?

Correct Answer is C

Explanation

A nurse is caring for a client receiving intravenous (IV) heparin therapy for deep vein thrombosis (DVT). What is the nurse's priority action to ensure safe administration of the medication?

Correct Answer is D

Explanation

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