Blood Flow Basics
Jonathan’s swollen, warm calf is caused by a clot blocking what type of blood vessel?
Vein
- A deep vein thrombosis occurs when a blood clot forms in a deep vein, leading to swelling, warmth, and pain in the affected limb
Name 1 anticoagulant?
Heparin, enoxaparin sodium, warfarin sodium, apixaban, rivaroxaban
Name one symptom of a DVT
Edema, pain, warmth, erythema, dilated superficial veins
- Common symptoms of a DVT include edema, pain, warmth, erythema, and dilated superficial veins in the affected extremity.
What vital sign change is often seen with pain or anxiety?
Increased heart rate
- Increased heart rate (tachycardia) and sometimes elevated blood pressure are common responses to pain or anxiety due to sympathetic nervous system activation.
What type of diabetes does Jonathan have?
Type II
What vessels carry blood away from the heart?
Arteries
- Arteries are the vessels that carry blood away from the heart as part of systemic circulation
What common side effect of morphine should the nurse monitor for?
Respiratory depression
- Respiratory depression is a common and serious side effect of morphine, so the nurse should monitor respiratory rate, depth, and oxygen saturation regularly
Where is the most common location(s) of a DVT?
Lower leg, thigh, or pelvis
- DVTs most commonly form in the deep veins of the lower extremities, especially the calf and thigh, due to venous stasis after surgery or immobility.
A sudden drop in oxygen saturation is a red flag for what?
Hypoxia
- A sudden drop in oxygen saturation is a red flag for hypoxia, which can indicate serious complications such as a pulmonary embolism or impaired gas exchange.
What is the primary goal of diabetes management?
Maintaining normal blood glucose levels
- The primary goal of diabetes management is to maintain blood glucose within a target range to prevent both acute complications (like hypoglycemia or hyperglycemia) and long-term complications such as vascular damage.
What should the nurse check on the leg after surgery?
Swelling, color, temperature, pulses, and/or movement
-Assess the surgical leg for swelling, color, temperature, pulses, and signs of pain or redness to detect complications such as DVT or impaired circulation
True or false? A nurse should check the dose with another nurse before administering Heparin
True
- Heparin is a high-risk medication, and doses must always be checked independently by another nurse to prevent medication errors
What is one nursing intervention to prevent DVT formation postoperatively?
SCDs, compression socks, ambulation
- Sequential compression devices (SCDs), compression stockings, and early ambulation are effective nursing interventions to promote venous return and prevent DVT in postoperative patients.
Jonathan weighs 131.8 kg. What does this put him at risk for?
Venous stasis
- Obesity increases the risk of venous stasis, making patients more prone to deep vein thrombosis (DVT) and other vascular complications after surgery.
What medicine does he take to control blood sugar?
Metformin
What activity helps prevent stiffness after knee surgery?
Range of motion, ambulation
- Early ambulation and gentle range-of-motion exercises help maintain joint mobility, prevent stiffness, and reduce the risk of complications
Which lab value should the nurse monitor closely while giving anticoagulants?
INR
- When a patient is receiving anticoagulants, the nurse should closely monitor INR to ensure therapeutic effect and prevent bleeding complications.
What are the three main risk factors of a DVT (Virchow's Triad)
Hypercoagulable state, endothelial injury, venous stasis
- Virchow’s Triad includes three main risk factors for DVT: venous stasis, endothelial injury, and hypercoagulability. These factors contribute to clot formation, especially after surgery or prolonged immobility.
What abnormal vital sign puts someone at risk for vascular disease?
High blood pressure
- Elevated blood pressure (hypertension) is an abnormal vital sign that increases the risk for vascular disease, including atherosclerosis, stroke, and heart attack.
What food can help if blood sugar is too low?
Juice, sugar packets, candy, soda
- Consuming a fast-acting carbohydrate quickly raises blood glucose levels during hypoglycemia
Which side of the heart pumps blood to the whole body?
Left side of the heart
- The left ventricle pumps oxygenated blood into the systemic circulation, delivering it to the entire body
What is the action of Heparin?
Inactivates factor X and blocks the formation of thrombin from prothrombin
What life-threatening complication can result from a DVT traveling to the lungs?
Pulmonary Embolism
- A pulmonary embolism (PE) can occur if a DVT clot dislodges and travels to the lungs, blocking pulmonary blood flow and causing a potentially life-threatening emergency.
What happens to blood pressure when arterial elasticity decreases?
Increases
- When arterial elasticity decreases, systolic blood pressure rises, increasing the risk for hypertension and vascular complications.
Why does diabetes make surgery recovery harder?
High blood sugar delays healing
- Diabetes impairs wound healing and increases infection risk due to high blood glucose levels affecting immune function and tissue repair, making postoperative recovery more challenging.