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**Case Study-Deep Vein Thrombosis**

Melody Smith is a 57-year old, 1 ½ pack per day (PPD) smoker. She works as a secretary in a legal office. When Melody woke this morning she noticed that she was experiencing right calf pain and some slight swelling. She also noticed that her calf was warm to the touch. Melody decided to go to her primary healthcare provider’s office for advice.

Data obtained from the nursing assessment includes the following information:

- Vital signs: B/P 130/78, HR 94, RR 20, Temp. 100.8 F
- Lungs sound clear
- Heart sounds S1, S2, present, clear, & audible
- ECG shows an atrial fibrillation

Melody’s provider orders a PTT, PT, and INR; WBC, platelet count, and an ultrasound of the right lower leg.

It is confirmed that she has a deep vein thrombosis and she is admitted to the hospital.

After 3 days in the hospital receiving heparin IV, the provider orders oral warfarin (Coumadin) for discharge and a weekly PT and INR test.

**QUESTIONS**

- What are the contributing factors that led to the development of Ms. Smith’s DVT?
- What is the significance of the weekly blood work?
- What are possible complications if the DVT is not treated?
- What patient education will need to be done?

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