Answers
Contributing factors
In these case clearly explained that smith is a "chronic smoker".Smoking is a main risk factor for developing DVT.In case of smokers the blood is more "sticker" which can easily develop DVT.That may developed symptoms like calf muscle pain, swelling, unable to stand prolonged period, twitching sensation.
Other isk factor are heredity, prolonged bed stay, paralysis patient, pregnancy, over weight.
Blood investigation :
Weekly blood investigation like PT, INR, APTT will gives idea regarding dose adjustments of oral Warfarin. And also how the oral blood thinners effective. Could be maintain INR level in a normal parameters other wise patient chance to high risk for bleeding. If the client must check and inform the concern certified doctors.
Complications of DVT:
Main complications are;
Pulmonary embolism :
The blood clots are dislodge and travel toblung and block a major blood vessel that may leads to pulmonary embolism. Patient may occur sudden breathing difficulty, chest pain, sweating.
It's a major complication of DVT.
Venous insufficiency and post traumatic syndrome :
It can occur when the lower limb veins are damaged and unable toto fuction normally. Which can leads to slowdown venous return, and that may leads to pooling of blood there itself. Leads to pain, swelling. In post tramatic syndrome persist may leads to ulcer & wound.
Patient education :
* Explain detaily about the importance of blood thinners. Continue oral warfarin daily as per doctors order.
Don't skip the medication unless doctors order. The blood thinners not been break the clots and it's prevent development of new clots and reduce risk for reoccurrence.
* Stockings :lower limb stockings are available could reduce the chance to develope new clots.
* Early ambulatiion promoted. Bt not being done strained activities.
* Explain the risk for bleeding. Because of the use of blood thinners. In case any sign of bleeding like oral bleeding, nose bleeding should inform to the doctors.
* If the client slip & fall or took treatment for any other secondary disease should inform the concern doctor regarding she is regularly taken warfarin.
* Done daily activities as much as possible.
* proper followup with the health care providers.
* weekly blood test must be done to prevent further complications associated with oral warfarin.
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