Deep-Vein Thrombosis Arturo Espinoza is a 72-year-old retired cook with a history of ASHD and HTN. He also had an Ml a y

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Deep Vein Thrombosis Arturo Espinoza Is A 72 Year Old Retired Cook With A History Of Ashd And Htn He Also Had An Ml A Y 1 (58.59 KiB) Viewed 39 times

Deep Vein Thrombosis Arturo Espinoza Is A 72 Year Old Retired Cook With A History Of Ashd And Htn He Also Had An Ml A Y 2 (19.25 KiB) Viewed 39 times

Deep-Vein Thrombosis Arturo Espinoza is a 72-year-old retired cook with a history of ASHD and HTN. He also had an Ml a year ago. He is 5'9", weighs 220 pounds, and has been a pack- a-day smoker for 45 years. He recently noticed a deep, intense aching in his right lower leg but does not recall having injured it. Over the next few days, his right calf became tender and erythematous. In addition, his right lower leg. from the knee down, has become edematous. After being evaluated by his family physician, Mr. Espinoza was diagnosed with deep-vein thrombosis (DVT) and started on SubQ heparin injection therapy twice each day (bid). After several days of heparin therapy, Coumadin was started as well. Both PTT and INR levels were monitored. Once Mr. Espinoza achieved a therapeutic level of his Coumadin, he was able to discontinue the heparin. Coumadin therapy is planned for the next 3 to 6 months, and he will return on a monthly basis for monitoring. Venous thromboembolism (VTE) is a condition in which a thrombus, or blood clot, develops within a vein. When inflammation also develops, the condition is known as deep-vein thrombosis (DVT) or thrombophlebitis. This condition can occur in any vein but is most common in the deep veins of the legs. Risk factors for DVT include recent surgery, venous stasis from immobility, obesity, increased blood coagulability, and vascular injury. People with an increased risk include the elderly, smokers, and women over 30 years old who use oral contraceptives. If the blood clot breaks off and moves to the lungs, it is called a pulmonary embolism (PE). In recent years, increased attention has been paid to the occurrence of DVT among airline passengers. Some have called it economy-class syndrome because of the prolonged sitting required of these passengers, which can cause venous stasis. Risk of this syndrome could be minimized if passengers were able to exercise their feet and legs every 1 to 2 hours by walking in the aisles or doing range-of-motion exercises while sitting. Remaining well hydrated and wearing support hose are also helpful. Treatment goals for DVT are to prevent the blood clot from getting bigger and to prevent it from breaking off and moving to the lungs. Treatment may include rest, elevation of the extremity, compression stockings, and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and anticoagulants. A variety of anticoagulant medications are available: some of the most commonly used include heparin, Lovenox, and Fragmin. Heparin levels must be monitored by checking the PTT. After several days, warfarin (Coumadin) therapy is started. Blood levels of this medication are monitored by checking the INR. These medications slow the patient's blood-clotting time, which prevents further clot formation while the body's natural mechanisms dissolve the present clot. A potential side effect of these medications is easy bruising and increased risk of bleeding. Therefore, patients are counseled to watch for signs of bleeding when, for example, passing bowel movements or brushing or flossing the teeth.
movements of Dr Questions: 1. What known risk factor for DVT does Mr. Espinoza have? What disorder does Mr. Espinoza have (use medical term and define medical term). 2. By what route did Mr. Espinoza receive his heparin? 3. What lab test was done to determine whether Mr. Espinoza's heparin dose was correct? What lab test was done to determine whether Mr. Espinoza's Coumadin dose was correct? Describe/Define each lab test. 4. How is DVT treated? Use medical terms and define each medical term used. 5. Why has economy-class syndrome become a recent popular name for DVT? 6. Create a list of ways to decrease the risk for development of DVT. another illness procedure treatment