Deep vein thrombosis renders a person at risk of?

AIIMS Nagpur NO - 2018

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Nagpur NO - 2018

Explanation

Deep Vein Thrombosis (DVT) is the formation of a blood clot in a deep vein, most commonly in the legs.
The most serious and life-threatening complication occurs when a piece of the clot breaks off, becoming an embolus.
This embolus travels through the venous system, through the right side of the heart, and lodges in the pulmonary artery, causing a blockage known as a Pulmonary Embolism (PE).
As clearly shown in the provided image, this blockage obstructs blood flow to the lungs, which can be fatal. Over 95% of PEs originate from DVTs in the legs.

Option A: Shock is not a direct complication of DVT. It is a state of systemic circulatory failure.
Option C: A heart attack (myocardial infarction) is caused by a blockage of the coronary arteries supplying the heart muscle.
Option D: An ischemic stroke is caused by a blockage in an artery supplying the brain. A clot from a DVT is in the venous system and is filtered by the lungs.

Visual 1: Infographic - Virchow's Triad (stasis, hypercoagulability, and endothelial injury) to explain the three main factors contributing to DVT formation.
Visual 2: Diagram - Signs and symptoms of Pulmonary Embolism, such as sudden shortness of breath, sharp chest pain, and tachycardia, to help in early recognition.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Deep Vein Thrombosis (DVT) as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in preventing DVT in at-risk patients (e.g., post-operative, immobilized) through early ambulation, compression stockings, and administering prescribed anticoagulants.
Nursing assessment for DVT includes checking for unilateral leg swelling, pain, warmth, and redness. It's critical to report these signs immediately as Homan's sign is no longer considered a reliable indicator.
What if? If a patient with a known DVT suddenly develops shortness of breath, chest pain, and tachycardia, the nurse's priority is to raise the head of the bed to facilitate breathing, apply oxygen as prescribed, and call for immediate medical assistance (e.g., Rapid Response Team), as these are classic signs of a pulmonary embolism.

How to Approach the Question

First, identify the core concept in the question, which is 'Deep vein thrombosis (DVT)' and the associated 'risk'.
Recall the pathophysiology of DVT. A DVT is a clot in the venous system, typically the legs.
Trace the path of blood flow from the deep veins of the leg. Blood flows towards the heart, enters the right atrium, then the right ventricle, and is then pumped to the lungs via the pulmonary artery.
Consider what happens if a piece of the clot breaks off (embolizes). It will follow this path and get stuck in the smaller vessels of the lungs.
Evaluate the options based on this pathway. A clot lodging in the lungs is a 'Pulmonary embolism'. The other options (Heart attack, Stroke) involve the arterial system, which a venous clot normally cannot reach.

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