The most important risk of deep vein thrombosis (DVT) is?

SCTIMST Staff Nurse - 2015 (Set-A)

Medical Surgical Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

The most critical and potentially fatal complication of a deep vein thrombosis (DVT) is a pulmonary embolism (PE).
A PE occurs when a fragment of the thrombus breaks off from a deep vein (usually in the leg), travels through the bloodstream, and lodges in the pulmonary arteries.
This blockage obstructs blood flow to the lungs, leading to impaired gas exchange, hemodynamic instability, and, in severe cases, shock or sudden death.
More than 95% of pulmonary emboli originate from DVTs in the lower extremities, making it the most direct and severe risk.

Option A: Myocardial infarction (heart attack) is caused by the blockage of coronary arteries, which supply blood to the heart. It is an arterial event, whereas DVT is a venous problem.
Option C: Phlebitis is inflammation of a vein. While DVT is a form of thrombophlebitis, the local inflammation itself is not the most life-threatening risk. The danger lies in the clot dislodging.
Option D: Bleeding is not a risk of the DVT itself. Instead, it is the most significant risk associated with the anticoagulant medications (like heparin and warfarin) used to treat DVT.

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.
A nurse's primary role is vigilant monitoring for signs of PE in any patient with a known or suspected DVT. Key symptoms include sudden onset of dyspnea, pleuritic chest pain, tachycardia, and unexplained anxiety.
If a PE is suspected, the nurse must immediately elevate the head of the bed, apply oxygen, notify the Rapid Response Team or physician, and prepare for emergency interventions like anticoagulation or thrombolysis.
What if? If a patient with a DVT is on anticoagulants and starts showing signs of bleeding (e.g., nosebleeds, hematuria), the priority shifts. The nurse must stop the anticoagulant infusion (if applicable), notify the provider immediately, and prepare to administer reversal agents (like Vitamin K for warfarin or protamine sulfate for heparin).

How to Approach the Question

First, identify the core concept of the question, which is the primary complication or risk of Deep Vein Thrombosis (DVT).
The keyword is "most important," which directs you to prioritize the options based on severity and potential for mortality.
Evaluate each option's relationship to DVT. Ask yourself: 'Is this complication directly caused by a clot in a deep vein?'
Analyze Option A (Myocardial infarction): This is an arterial problem in the heart, not a direct result of a venous clot from the legs.
Analyze Option B (Pulmonary embolism): This is a well-known, direct, and life-threatening consequence of a DVT dislodging and traveling to the lungs.
Analyze Option C (Phlebitis): This is local inflammation and is part of the DVT process itself, but it's not the most severe systemic risk.

Concept Tested & Keywords

QOIOlTSNo9tqluI_cUkp6x

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 139-141

E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 1 (1-214) p. 205-207

E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 132-134