According to Chisholm-Burns et al., deep vein thrombosis (DVT) is the result of venous thromboembolism (VTE) and can lead to pulmonary embolism, (PE). Deep vein thrombosis (DVT) is the result of a clot (blood that aggregates together) situated in a deep vein of the lower extremities (National Library of Medicine -PubMed Health, n.d.).
Pathophysiology of DVT “Deep venous thrombosis usually arises in the lower extremities. Most DVT’s forms in the calf veins, particularly in the Soleus sinusoids and the cusps of the valves” (McMaster Pathophysiology Review, 2011),
• Valves: Due to the obstruction, flow of blood decreases oxygenation, which leads to a hypoxic endothelium. This in turn causes a cascade of events via an extrinsic factor.
• Skeletal
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Relias (2008) ask the following questions when patients present with redness and swelling of the lower extremities: Any cardiac history? Any long hours of traveling? and have you increased your exercise level? Let’s look at a case study of a 52-year-old female and continue an assessment and treatment. Complete Physical Examination
Informant: Patient who reliable and good historian.
Chief Complaint: Questioning why INR is elevated and wants to know for how long she should take Coumadin. Follow-up appointment after treatment of thrombolysis.
History of Current Illness: A 52-year-old female with history of hypertension and asthma. Positive for Factor V Lieden. Surgical procedure: Thrombolysis to left leg on last admission. Reports decrease swelling and tenderness to left leg. Self-monitors INR at home.
Current Medications:
Coumadin 8 mg once daily. HCTZ 25 mg once daily. Advair 250/50 once daily
Past Health
General: Relatively in good health.
Allergies: No known allergies.
Immunizations: No pneumonia or flu vaccine information.
Laboratory Results
CBC: WBC- 10.2 HGB- 13 HCT- 40 PLT- 326
BMP: Glucose- 145 BUN- 24 Creat-1.4 K-
Therapeutic responses: decreased bleeding tendencies, decreased PT, decreased clotting time. Teach patient/ family Not to take other supplements unless directed by prescriber. The necessary foods for diet. To avoid IM inj, use soft tooth-brush, do not floss, use electronic razor until coagulating defects corrected.
IV bolus of unfractionated Heparin or Subcutaneous injection of low molecular weight heparin (LMWH) may be used to prevent the formation of new blood clots. Nursing consideration: Require regular monitoring of activated partial thromboplasitn time (aPTT) and needed frequent heparin dose changes (Brunner and Suddarth’s, et al, 2010: 765). Fibrinolytic therapy: This therapy is given to dissolve the thrombus in the artery and restore the blood flow. There are two fibrinolytic drugs which are streptokinase and Recombinant tissue plasminogen activators (r-TPA) which includes Alteplase, reteplase and tenecteplase (Brunner and Suddarth’s, et al, 2010: 772).
Family History also is positive for rheumatoid arthritis (Inflammatory changes in the joints causing pain), so we had serology (scientific study of blood or other bodily fluids) run for the erythrocyte sedimentation rate (the rate at which red blood cells settle in one hour used to detect inflammation associated with conditions such as infections, cancers, and autoimmune diseases), and looking for presence of Anti-Nuclear-Antibodies (found in patients whose immune system may be predisposed to cause inflammation against their own body
Jimmie Bowman was seen in followup for CIDP, causing previous weakness and numbness of his distal lower extremities. He states that the strength of his distal lower extremities [____] continues improved and is staying normal. He has occasional mild feeling of numbness of his feet, but states this is staying down to what he can tolerate. He is not having pain of his feet. He is no longer on Imuran.
Ms. Cardiello reported that she also suffers from moderate to severe anemia. Ms. Cardiello reported that she get IV infusions of iron every 8 to 12 weeks, she indicated when she experiences pain she takes
Chemo plan is q2weeks and the apt on 5/23/16 should have been cancelled, (9) Zometa patient - yellow dot - Calcium and SCr labs were from 03/26/2016. After discussing the above findings. We both agreed that your work the last two days have been sloppy. You work lacks the meticulous and attention to details required for you to to safely and competently function as an oncology/infusion pharmacist in this clinic. I am very concern with the quality/consistency of your work.
The patient follows the doctor’s recommendation for completing blood work to ensure the medication is consistently within the therapeutic level. Therefore, the International Normalized Ratio (INR), prothrombin time
TASK 3.1 Write a report comparing and contrasting the structure and function of the three types of blood vessels. The Structure and Functions of Blood Vessels ARTERIES The walls of arteries contain smooth muscle fibre that contract and relax under the instructions of the sympathetic nervous system. The functions of the arteries are: transport blood away from the heart and transport oxygenated blood only.
Jean Russell of Michigan Insurance Company referred this file for medical case management. Instructions were given to meet with Flavia Tocco and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING I met Ms. Tocco at the St. John’s physical therapy department. Ms. Tocco was open to providing me information on her current and prior medical history.
Michaela P. Capulong NU 333-01: Physical Assessment for the Nursing Professional June 29, 2015 Journal 7 When I do my assessment on admission, I always include the assessment findings that I expect to be abnormal if the patient has definite cardiovascular problem. I notify the MD and the nurse practitioner immediately if I find abnormal findings or values. I ensure to chart the education and the correction in response of the abnormal findings. In addition to that, tests and labs should be done to rule out problems. It is essential to know the patient’s health history before conducting the physical exam.
While waiting for BNP test result mrs.Smith is referred to medical team for further investigation when the medical registrar came to review mrs . Smith BNP result arrived and which was normal, 75 pg/mL. Medical registrar examined mrs.Smith and adviced to give a stat dose of iv Augmentin 1.2 gm because of the elevated CRP. Confirmed with mrs.Smith that she is not allergic with any medication. Doctor adviced to
The patient BAC was .34 when lab were conduct. The patient reports a non-compliance with his medications for 3 weeks. The patient reports that he was unable to fill them a few months ago with DayMark. The patient reports that he has been depressed recently. Furthermore, he reports that both of his parents died years ago around this time of year and he tries to block out the thought of both their deaths.
The emergency room physician, David C. Lee, M.D., ordered medication, a series of diagnostic tests, and blood cultures, and he admitted Mrs. Adae to the hospital for further observation and testing, in order to rule out myocardial infarction and ACS. Dr. Lee listed "infectious etiology" in his differential diagnoses. Jennifer Bain, M.D., came on duty as an attending physician during the morning of June 29, 2006. Dr. Bain, an employee of UC, recorded her suspicion that Mrs. Adae 's chest pain was musculoskeletal. Dr. Bain noted that Mrs. Adae 's EKG, cardiac enzymes, and blood tests, with the exception of her elevated blood sugar, were normal.
The patient was diagnosed for polyps and multiple diverticula at the age of 68. The Patient suffers of painful osteoarthritis of both knees, shoulder hips. Patient?s mother deceased at the age of 79 from breast cancer and her father deceased at the age of 54 from heart attack. The patient noted with bilateral lower extremities edema, and claimed that she uses 2 pillows as a comfortable position to sleep,
By Jonas Wilson, Ing. Med. Vascular Surgery The surgical branch dealing with disorders of the circulatory system, which includes arteries, veins and lymphatic vessels, is called vascular surgery.