Sample Answer for NURS 6050 Cardiovascular Disorders Included After Question
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
- myocardial infarction
- endocarditis
- myocarditis
- valvular disorders
- lipid panels
- coagulation
- clotting cascade
- deep vein thrombosis
- hypertension
- heart failure
- COPD
- asthma
- pneumonias
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 7 OF WEEK 3
Complete the Knowledge Check by Day 7.
A Sample Answer For the Assignment: NURS 6050 Cardiovascular Disorders
Title: NURS 6050 Cardiovascular Disorders
Primary Diagnosis: Deep-vein thrombosis (DVT)
- Describe the pathophysiology of the primary diagnosis in your own words. What are the patient’s risk factors for this diagnosis?
| Pathophysiology of Primary Diagnosis | |
| Navarrete et al. (2022) identified three primary pathophysiological mechanisms contributing to deep vein thrombosis (DVT): vessel wall damage, blood flow turbulence, and hypercoagulability. Thrombosis serves as a protective mechanism by preventing blood loss and sealing damaged blood vessels. Fibrinolysis can either counteract or stabilize thrombosis. Venous thrombosis triggers are often multifactorial, involving various components of Virchow’s triad. These factors contribute to the early interaction between the thrombus and the endothelium in each patient. This process induces the production of cytokines at the local level and leads to the adherence of leukocytes to the endothelium, thereby facilitating the development of venous thrombosis. Thrombosis can spread depending on how well the clotting and thrombolytic processes work together. The most prevalent location for DVT is in the lower leg below the knee. It begins in low-flow places behind venous valve pockets, such as the soleal sinuses. | |
| Causes | Risk Factors (genetic/ethnic/physical) |
| Any factor that obstructs blood flow or impairs clotting can lead to the formation of a blood clot. DVT is primarily caused by surgical vein damage, inflammation, infection, or injury (Monreal et al., 2019). | Numerous factors can elevate the likelihood of developing DVT. Risk factors for DVT encompass advanced age (above 60 years), immobility, injury or surgical procedures, pregnancy, utilization of birth control pills or replacement hormones, obesity, smoking, presence of cancer, cardiac failure, inflammatory bowel disease, and personal or familial history of DVT or pulmonary embolism (Fujioka et al., 2020). |
2. What are the patient’s signs and symptoms for this diagnosis? How does the diagnosis impact other body systems, and what are the possible complications?
| Signs and Symptoms – Common presentation | How does the diagnosis impact each body system? Complications? |
| The primary symptoms of acute DVT typically consist of pain, swelling, redness, tenderness, fever, significant superficial veins, pain when the foot is passively flexed upwards (known as Homan’s sign), and peripheral cyanosis. Phlegmasia cerulea dolens, which is distinguished by distress, cyanosis, and massive edema, is the most severe manifestation of acute DVT of the lower extremities. It arises from the complete occlusion of the venous discharge of the affected extremity (Monreal et al., 2019). | Symptoms of DVT include microvascular thrombosis and collateral vein thrombosis, which may progress to venous gangrene in more severe instances (Duffett, 2022). Major complications of DVT encompass pulmonary emboli, post-thrombotic syndrome, and anticoagulant-induced bleeding. |
3. What are other potential diagnoses that present similarly to this diagnosis (differentials)?
Several additional illnesses exhibit signs and symptoms that closely resemble those of DVT and pulmonary embolism. Instances such as muscular damage, cellulitis, and inflammation of superficial veins might imitate the indications and manifestations of DVT (Fujioka et al., 2020).
4. What diagnostic tests or labs would you order to rule out the differentials for this patient or confirm the primary diagnosis?
An imaging examination called duplex ultrasonography looks at the blood flow in the veins using sound waves. It can identify obstructions or thrombi in the deep veins. According to Fu et al. (2020), this imaging test is the norm for diagnosing DVT and ruling out other possible diagnoses. A blood test called a D-dimer analyses a chemical released into the bloodstream after clot disruption. A negative D-dimer test result indicates that the patient is unlikely to be experiencing a blood embolism.
5. What treatment options would you consider? Include possible referrals and medications.
Anticoagulants, sometimes known as “blood thinners,” are the primary drugs used for the treatment of DVT (Sagris et al., 2022). Despite its name, blood thinners do not really cause a thinning of the blood. They inhibit the coagulation process of the blood, impeding the enlargement of the clot as the body gradually absorbs it and decreasing the likelihood of more clots forming. Fondaparinux, low molecular weight heparin, and unfractionated heparin are the injectable anticoagulants that are most often used. Oral (swallowed) anticoagulants consist of Dabigatran, Rivaroxaban, Apixaban, Warfarin, and Edoxaban. Due to the potential for bleeding, close monitoring is necessary for those taking any anticoagulant medication to avoid the occurrence of abnormal bleeding. Deep vein thromboses (DVTs) can lead to extended hospital stays and pharmacological therapy that may span from 3 to 9 months, contributing to the overall healthcare expenses. Upon diagnosis of DVT, the recommended course of treatment involves administering an anticoagulant for a period of 3 to 6 months. Additionally, regular monitoring of the International Normalised Ratio (INR) by a hematology nurse or chemist is necessary. Referrals to vascular surgeons and hematologists may also be made.
References
Duffett, L. (2022). Deep Venous Thrombosis. Annals of Internal Medicine, 175(9), ITC129–ITC144. https://doi.org/10.7326/aitc202209200
Fu, Y.-H., Liu, P., Xu, X., Wang, P.-F., Shang, K., Ke, C., Fei, C., Yang, K., Zhang, B.-F., Zhuang, Y., & Zhang, K. (2020). Deep vein thrombosis in the lower extremities after femoral neck fracture: A retrospective observational study. Journal of Orthopaedic Surgery, 28(1), 230949901990117. https://doi.org/10.1177/2309499019901172
Fujioka, S., Ohkubo, H., Kitamura, T., Mishima, T., Onishi, Y., Tadokoro, Y., Araki, H., Matsushiro, T., Yakuwa, K., Miyamoto, T., Torii, S., & Miyaji, K. (2020). Risk Factors for Progression of Distal Deep Vein Thrombosis. Circulation Journal, 84(10), 1862–1865. https://doi.org/10.1253/circj.cj-20-0270
Monreal, M., Agnelli, G., Chuang, L. H., Cohen, A. T., Gumbs, P. D., Bauersachs, R., Mismetti, P., Gitt, A. K., Kroep, S., Willich, S. N., & Van Hout, B. (2019). Deep Vein Thrombosis in Europe—Health-Related Quality of Life and Mortality. Clinical and Applied Thrombosis/Hemostasis, 25, 107602961988394. https://doi.org/10.1177/1076029619883946
Navarrete, S., Solar, C., Tapia, R., Pereira, J., Fuentes, E., & Palomo, I. (2022). Pathophysiology of deep vein thrombosis. Clinical and Experimental Medicine, 1(1). https://doi.org/10.1007/s10238-022-00829-w
Sagris, M., Tzoumas, A., Kokkinidis, D. G., Korosoglou, G., Lichtenberg, M., & Tzavellas, G. (2022). Invasive and Pharmacological Treatment of Deep Vein Thrombosis: A Scoping Review. Current Pharmaceutical Design, 28(10), 778–786. https://doi.org/10.2174/1381612828666220418084339