Clotting/ Venous Thrombosis: Case Study You are

Clotting/ Venous Thrombosis: Case Study You are assigned to care for L.J., a 70-year-old retired bus driver who has just been admitted to your medical floor with right leg deep vein thrombosis (DVT). L.J. has a 48-pack-year smoking history, although hesitates he quit 2 years ago. He has had pneumonia several times and frequent episodes of atrial flutter or fibrillation. He has had two previous episodes of DVT and was diagnosed with rheumatoid arthritis 3 years ago. Two months ago, he began experiencing shortness of breath on exertion and noticed swelling of his right lower leg that became progressively worse until it extended up to his groin. His wife brought him to the hospital when he complained of increasingly severe pain in his leg. When a Doppler study indicated a probable thrombus of the external iliac vein extending distally to the lower leg, he was admitted for bed rest and to initiate heparin therapy. His basic metabolic panel was normal; other laboratory results were as follows. Laboratory Testing PT 12.4sec INR 1.11 aPTT 25sec Hgb 13.3g/dL Hct 38.9% Cholesterol 206mg/dL 1) Keeping in mind L.J.’s health history and admitting diagnosis, what are the most important assessments you will make during your physical examination and assessment. 2) What is the most serious complication of DVT? 3) List at least eight assessment findings you should monitor closely for in the development of the complication identified in Question 5.

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