A postnatal mother receiving treatment for deep vein thrombosis should be watched for?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016

Obstetrics & Gynaecology

Medium

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016

Explanation

Treatment for Deep Vein Thrombosis (DVT) involves anticoagulant medications, commonly known as blood thinners.
The most significant and dangerous side effect of anticoagulant therapy is hemorrhage, or bleeding.
Therefore, a nurse must monitor for signs of bleeding.
Hematuria (blood in urine), ecchymosis (easy bruising), and epistaxis (nosebleeds) are all classic signs of excessive anticoagulation and potential bleeding.

Option A: This option includes dysuria and vertigo. Dysuria (painful urination) is a symptom of a urinary tract infection, not a direct sign of bleeding from anticoagulants. Vertigo is a non-specific symptom.
Option B: This option includes dysuria. While epistaxis and hematuria are correct signs of bleeding, the inclusion of dysuria (a symptom of a UTI) makes the entire option incorrect.
Option C: This option is incorrect because it includes the non-specific symptom of vertigo and is redundant, listing hematuria twice.

Clinical Relevance

Nursing practice connection: Knowing Monitoring for side effects of anticoagulant therapy in a patient with Deep Vein Thrombosis (DVT) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Patient education is a critical nursing role. The nurse must teach the patient and family to recognize and immediately report any signs of bleeding, such as unusual bruising, nosebleeds, or blood in the urine or stool.
Monitoring lab values like INR (for warfarin) and aPTT (for heparin) is essential to ensure the anticoagulant dose is within the therapeutic range and not at a toxic level that increases bleeding risk.
What if? If the patient reports black, tarry stools (melena) in addition to epistaxis, the nurse should hold the next dose of anticoagulant (if permitted by protocol) and notify the healthcare provider immediately. This combination suggests gastrointestinal bleeding, a medical emergency.

How to Approach the Question

First, identify the core of the question: what are the side effects of DVT treatment?
Recall that DVT is treated with anticoagulants (blood thinners).
Determine the primary and most dangerous side effect of anticoagulants, which is bleeding (hemorrhage).
Evaluate each option to see which one contains a list composed entirely of bleeding-related signs.
Eliminate options containing signs unrelated to bleeding, such as dysuria (a symptom of a UTI) or vertigo (a non-specific symptom).
Select the option that lists only classic signs of bleeding: hematuria, ecchymosis, and epistaxis.

Concept Tested & Keywords

Concept Tested: Monitoring for side effects of anticoagulant therapy in a patient with Deep Vein Thrombosis (DVT).
Stem keywords: postnatal mother, deep vein thrombosis, DVT, treatment
Lead-in keywords: watched for
Clinical cues: The patient is postnatal, which is a risk factor for DVT.
Clinical cues: The patient is receiving treatment, which implies the use of anticoagulants.

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 54-68

E6 Medicine Davidson Principles Practice 24e p. 995-997