Chapter 19: Disorders of the Venous System
A registered nurse is teaching a group of nursing students about Homan's sign. Which statement made by the student nurse indicates effective learning?
"Place the client in the supine position with a straight knee and dorsiflex the client's foot."
The nurse uses Homan's sign to assess a client for the presence of deep venous thromboembolism (DVT). Pain in what area is an indication of positive Homan's sign?
Calf
What is the purpose of a Greenfield filter?
To prevent a blood clot from traveling
A client with left lower extremity swelling and tenderness along a vein has to be assessed to rule out deep vein thrombosis (DVT). Which criteria would rule out DVT?
A negative D-dimer assay and Wells criteria score of less than 2
A student nurse is learning to care for a variety of clients in a hospital setting. Which clients are most at risk for developing venous insufficiency? Select all that apply.
An obese client A pregnant client at 30 weeks gestation
Arrange the symptoms in the proper order to describe the pathophysiology of varicose veins (A-D). (Enter the number of each step in the proper sequence; do not use commas or spaces.)
Blood stagnation and pooling in the lower extremities. Pressure on the valves. Damaged valves. Compromised venous return.
A 60-year-old client is seen at the clinic with skin inflammation. There is dusky discoloration around the ankle and in the lower leg of the client. What might be the cause of this condition?
Buildup of hemosiderin
A client works as a sales associate in a garment outlet and has to stand for the duration of each work shift. Clinical examination reveals a presence of a dusky discoloration around the ankle, instep, and lower leg. What condition do these findings indicate?
Chronic venous insufficiency
A nurse is assessing four clients for deep vein thromboembolism (DVT). Which client is at a risk of developing DVT?
Client 1: Elevated 2
A nurse is reviewing the prescription records of four clients being treated for deep vein thromboembolism (DVT). Which client needs a prothrombin time lab test to monitor the therapeutic effects of the drug?
Client 2: Warfarin
A client reports to the hospital with a swollen mass on the left leg. Physical examination reveals that the swollen mass is red, tender, and is textured like a rope. A review of the client's records show that the client has recently undergone an orthopedic surgery on his right leg. Which condition has the client developed?
Deep venous thromboembolism
Which test is most commonly used to diagnose varicose vein?
Duplex ultrasound
A nurse is caring for a client with chronic venous insufficiency. Which instruction is appropriate to include in the client's care plan?
Elevate your legs periodically during the day
Arrange the pathophysiological changes involved in a pulmonary embolism (A-D). (Enter the number of each step in the proper sequence; do not use commas or spaces.)
Inflammation and thrombus form in the vein. The thrombus becomes an embolus and travels into the inferior vena cava. The thrombus travels into the right side of the heart. The thrombus then enters the pulmonary artery.
Which specific sign or symptom indicates that a client is suffering from varicose veins?
Itching and aching lower leg muscles
What are the diagnostic tests used for peripheral venous disorders? Select all that apply.
Photoplethysmography Doppler ultrasonography Venography
What condition can develop from a deep venous thrombosis (DVT) if it is not caught and treated early enough?
Pulmonary embolism
A client comes to the clinic with dark red edema on the lower leg, with irregular margins of skin breakdown especially in the medial ankle region. The primary health-care provider diagnoses necrosis and tissue damage surrounding the affected area. What treatment would the nurse expect to be prescribed for this client?
Topical medications
What is the outermost layer of the walls of a vein?
Tunica adventitia
Which is a cause for the occurrence of varicose veins?
Valvular incompetence in the legs
Which diagnostic test is used to identify the pattern of collateral blood flow?
Vegography
Which of the risk factors form part of Virchow's triad? Select all that apply.
Venous stasis Vascular damage Hypercoagulability
A client presents with a painful, swollen mass at the ankle of the right leg. Physical examination revealed that the edema is dark red in color, with drainage just above the medial malleolus of the leg. Which condition has the client developed?
Venous ulcer
Which drug administered to clients with deep venous thromboembolism (DVT) requires an international normalized ratio monitoring?
Warfarin
The tunica media is
the smooth muscle layer of the wall of a vein
