Peripheral Vascular Disease

Peripheral Vascular Disease
Background
Peripheral vascular disease is a disease that affects the peripheral circulatory system. PVD is also
referred to as peripheral arterial disease. PVD includes both the veins and the arteries. In PVD there
is a problem with blood flow due to a narrowing of blood vessels which is occurring from a different
pathology. The most common cause of PVD is atherosclerosis. Patients with PVD can range from
asymptomatic to severe and require amputations (Giorgi 2015).
Etiology
Peripheral vascular disease is divided into subcategories of functional and organic. "Functional PVD
does not involve physical problems in the blood vessels. It causes incidental or short–term
symptoms. These are usually spasms that occur erratically. Organic PVD involves changes in blood
vessel structure. This type of PVD causes inflammation, tissue damage, and blockages" (Giorgi
2015). The number one leading cause of peripheral vascular disease is atherosclerosis. "This is a
gradual process in which a fatty material builds up inside the arteries" (emedicinehealth 2015).
Other contributing factors to PVD include smoking, inactivity, diabetes, obesity, high blood
cholesterol, hypertension, emboli from another location, inflammation of blood vessels, injury to
blood vessels, and stress. (Giorgi 2015)
Pathology ... Show more content on Helpwriting.net ...
The final product is a plaque that then begins to narrow the path of blood flow in the arteries and can
potential cause a complete blockage. This can lead to ischemia and
... Get more on HelpWriting.net ...

Synthesis Of Most Coagulation Factors And Inhibitors
Discussion:
Liver has many haemostatic functions including the synthesis of most coagulation factors and
inhibitors as well as fibrinolytic factors. The balance between procoagulant and anticoagulant
factors is essential to prevent excessive blood loss from injured vessels and to prevent spontaneous
thrombosis (11).The global effect of liver disease with regard to hemostasis is therefore complex, so
that patients with advanced liver disease can experience severe bleeding or even thrombotic
complications (12).
Non– PVT group
At presentation (N=26)
After 6 months (N=26) p No
%
No
%
Gastropathy
Gastropathy grade I
3
11.53
4
15.3
0.6
Gastropathy grade II
4
15.38
3
11.5
Gastropathy grade III
3
11.53
0
0
Esophageal varices
OV I
2
7.69
3

11.5
OV II
3
11.53
3
11.5
0.09
OV III
5
19.23
2
7.6
OV IV
4
15.38
1
3.8
ISSN 2320–5407 International Journal of Advanced Research (2015), Volume 3, Issue 12, 1539 –
1548
1545
In our study as regards presence of co– morbid factors namely DM and hypertension, the prevalence
of DM and hypertension was higher in PVT group than non–PVT group, these results match the
findings reported by Martinelli et al. (13) who clarified that hypertension and DM were associated
with increased risk of PVT. That finding may be attributed to the association of dyslipidemia with
diabetes and increased risk of atherosclerosis, so patients with liver cirrhosis and associated diabetes
or hypertension carry the risk for PVT more than cirrhotic patients without them.
The

Spinal Cord Injury Essay example
Running head: SPINAL CORD INJURY
Spinal Cord Injury
Shannon G. Johnston, RN, CEN
Liberty University
Abstract
There are many types of spinal cord injuries (SCI). Patients with SCI can symptoms that range from
mild neurologic impairment (such as numbness and tingling of extremities or neck pain) to
devastating total body paralysis depending on the extent of damage and where in the spinal cord the
damage occurs. Management of airway, breathing and circulation are key with SCI patients, as well
as immediate immobilization. With proper care and intervention, chances of survival are greatly
improved.
Spinal Cord Injury
Spinal cord injuries (SCIs) most commonly occur as a result of falls, motor vehicle accidents,
violence, sports ... Show more content on Helpwriting.net ...
These injuries can also be classified as complete or incomplete. A complete SCI indicates no motor
function below the site of injury while incomplete SCIs can have some remaining level of sensory
and/or motor function below the level of injury.
Most vertebral injuries occur along the most mobile areas of the spinal cord, including C1–C2, C4–
C7, and T10–L2 (Huether, 2010). All of these injuries have the potential to be devastating. Spinal
shock can occur, resulting in complete loss of function. This is a temporary occurrence and usually
lasts up to 3 months after injury. It involves paralysis, loss of reflex, loss of bladder/bowel control
and sexual dysfunction. It can also cause systemic changes, such as loss of temperature control,
decrease in blood pressure, and poor venous circulation. When function returns, it is usually
demonstrated by return of movement, reflexes, and bowel/bladder control (Heuther, 2008).
As function returns, an uncompensated cardiovascular response can occur called autonomic
hyperreflexia. This is a life threatening emergency and must be treated immediately. If left
untreated, the result is death. Autonomic hyperreflexia displays as a dramatic rise in blood pressure,
pounding headache, excessive diaphoresis (sweating), nausea and bradycardia. This is caused by
"stimulation of the skin or pain

Early Immobilization In Hospitalized Patients
Early Mobilization in hospitalized patients There are notions among patients that being in the
hospital is the time to rest. While getting rest is important in the healing stage, too much bed rest can
cause complications. Early ambulation is not a new topic. Unfortunately new evidence suggests that
the earlier a patient is out of bed and walking, the better their outcome will be. Early ambulation is
not about how quickly a patient can move, but how often they move and the quality of those
movements. Even if a patient is unable to physically walk, simple movements such as sitting up in a
chair/wheel chair or dangling their legs is more beneficial than lying in bed. Some of the most
common complications due to immobility include loss of muscle strength, deep vein thrombosis,
contractures and soft tissue changes. While early ambulation may be contraindicated in unstable
patients, early ambulation decreases ... Show more content on Helpwriting.net ...
(Olson, E. V., Johnson, B. J., & Thompson, L. F., 1990). When patients are laying in certain
positions, that position may cause the thorax to compress, which decreases full chest expansions and
as a result decrease respiratory movements. Respiratory movement may also be hindered by
decreased muscle tone from prolonged bed rest.
We normally excrete secretions through movement, position changes and by coughing. When one of
these mechanisms is hindered, secretions are left in the lungs, which can cause infections such as
pneumonia and other respiratory issues. The combination of decreased respiratory movements and
collected secretions essentially causes deficient ventilation. This change can alter the normal
oxygen–carbon dioxide levels in the body. Prolongation of this problem will lead to increased
carbon dioxide in the lungs and cause

Hip Replacement Case Study
Complications from a hip replacement surgery can occur Post–operatively. One of these
complications includes deep vein thrombosis. DVT is a cardiovascular disease, in which a blood clot
forms in a vein deep in the body, commonly occurs in the lower leg or thigh. The clot can break
loose and travel within the body and block any blood vessels in the deep vein, this blockage of
vessels can occur in places such as the lungs or the brain, subsequently leading to death if not
treated immediately. When a patient is resting in bed for prolonged period of time after surgery the
body is not efficient in helping the blood to flow back to the heart from the lower extremities due to
the fact that the muscles in the lower extremities are not active, hence

The Venous System
Disorders of the Venous Systems The venous system of the lower extremities is composed of several
veins that are superficial and deep. The sophisticated blood flow of the lower extremity consists of
muscular venous pumps and bicuspid valves (Meissner, 2005). There are two major disorders of the
lower venous system, chronic venous insufficiency (CVI) and deep venous thromboses (DVT). It is
often assumed that disorders of the venous system are not relevant, but these disorders can, in fact,
be more complex to treat than arterial diseases. The purpose of this paper is to examine the
pathophysiology of CVI and DVT, diagnosis of the disorder, treatment of the disorder, comparison
of both disease and risk factors that affect the incidence of ... Show more content on Helpwriting.net
...
Testing for DVT consist of serum blood testing for specific enzymes called D–Dimer which is a
byproduct fibrinolysis; then it would suggest recent presence and lysis of thrombi (Douketis, 2016).
Other diagnostic procedures include duplex ultrasonography of the affected limb to determine blood
flow in the affected area and contrast venography. Treatment of DVT consists of anticoagulant
therapy intravenously, subcutaneously flowed by oral anticoagulant therapy for maintenance,
insertion of inferior vena cava filters, thrombolytic medications to dissolve the blood clot (Douketis,
2016). The last option for treatment of DVT is surgery which is rarely needed; thrombectomy is the
surgical procedure where the clot is removed manually from the place of

Hepatic Portosystemic Shunt Case Study
Four years ago, one of our long time family friend was diagnosed with Cirrhosis. This is a disease of
the liver that causes scarring and inflammation of the liver. The liver cells affected by cirrhosis start
to degenerate and affect functions of the liver. For sometime before, he had symptoms of abdominal
and legs swelling, blood in the stool and was suddenly gaining weight. The doctor described his
condition as end of liver stage disease that is preventing proper blood flow through the liver and
recommended transjugular intrahepatic portosystemic shunt (TIPS) procedure to be performed.
Transjugular intrahepatic portosystemic shunt (TIPS) is a less invasive procedure done by putting a
stent in a patient liver connecting portal vein and the hepatic vein in order to relive vascular blood
pleasure from the portal vein that can cause portal hypertension.
Liver is an important organ in human body. It has several important functions. This includes,
purifying blood by removing harmful substances, production of bile, and storage of nutrients. It also
acts as a passage of blood from the spleen and the gastrointestinal tract to the inferior vena cava.
Hepatic portal vein is the ... Show more content on Helpwriting.net ...
The hepatic portal hypertension is caused by the increase of blood flow from the abdominal cavity
and an increase of resistance to blood flow in the liver. When this condition happens, it can lead to
various complications this includes, swelling of the spleen, gastrointestinal bleeding, leg swelling
because of fluid, jaundice or the yellowing of skin, and accumulation of fluid in the abdomen.
Increase in hepatic portal vein pressure leads to collateral vessels formation that tries to bypass the
liver and drain the blood into the general circulation. This can result in developments of enlarged
varicose veins in the esophagus that may result to bursting and leaking

Venography Case Studies
An experienced board certified interventional radiologist read, analyzed and interpreted the CT
venography and DSA data. Clinical presentations, compression of the left common iliac vein by the
right common iliac artery, presence of collateral veins, narrowing of LCIV lumen and degree of
stenosis was considered as the diagnostic criteria for diagnosing MTS. The compression level of
LCIV was calculated and rated on CT using a method described by Narayan et al.(11) in which
distal RCIV was used as the reference denominator to calculate the percentage of left iliac vein
compression. The percentage was then used to rate compression level of LCIV as none (0%–25%),
mild (>25%–50%), moderate (>50%–75%) and severe (>75%). Many studies and literature(12)

Abnormal Factors And The Prevalence Of Dm And Hypertension
In our study as regards presence of co– morbid factors namely DM and hypertension, the prevalence
of DM and hypertension was higher in PVT group than non–PVT group, these results match the
findings reported by Martinelli et al. (13) who clarified that hypertension and DM were associated
with increased risk of PVT. That finding may be attributed to the association of dyslipidemia with
diabetes and increased risk of atherosclerosis, so patients with liver cirrhosis and associated diabetes
or hypertension carry the risk for PVT more than cirrhotic patients without them.
The number of patients who were smokers and users of contraceptive pills were also statistically
higher in PVT group than non–PVT group indicating that these factors may increase the risk for
PVT development in cirrhotic patients which goes in agreement with Shetty and Ghosh study (14).
These results may be attributed to the hypercoagulability caused by hormonal pills and increased
risk of atherosclerosis with smoking.
Risk factors:
PVT in patients with liver disease is the result of concomitant local and systemic thrombophilic
factors (15). In current study as shown in table (II) malignancy specially (HCC) was the most
common local risk factor for PVT followed by abdominal infection specially SBP then abdominal
intervention especially splenectomy. Similar results were also reported by other studies as Sogaard
et al.(6) in which abdominal inflammation especially pancreatitis was the most common risk factor
(19%)

Introduction. Glucagon And Insulin Are Hormones That Are
INTRODUCTION
Glucagon and Insulin are hormones that are secreted by the islet cells of the pancreas. The two
hormones are responsible for the control of glucose levels in the blood. The process ensures that
there is a constant supply of glucose to the cells to perform various functions in the body
consistently (Unger, Anna & Leonard 1031). The experiment compares the glucose concentration in
the mesenteric arteries, the hepatic vein, and the hepatic portal vein before and after food
consumption to establish the implication of the two hormones on the glucose levels. Mesenteric
arteries carry the blood from the rest of the body to the intestines and have little glucose (Unger,
Anna & Leonard 1033). Hepatic Portal Vein carries ... Show more content on Helpwriting.net ...
The labeling of test tubes was about the category and type of sample that was placed in each. A
metric ruler was used for marking off 1 cm and 2 cm on each test tube from the bottom to represent
the capacity of reagent and sample used in each set up of the experiment. The speed of reaction and
the extent of color change were compared with all the test tubes. A hot water bath was prepared for
the purpose of heating the test tube contents. It was filled with 200 mL of water and heated on high.
The respective serum was added to the six test tubes up to the first mark after which drops of
Benedict's solution were added to fill up to the second mark a piece. The three samples of post–
prandial were heated in the hot water bath concurrently. The time at which the solution color
changed for the first time and the color changes after that were noted down. The procedure was
repeated for the three samples taken during fasting. The expected order of the shift in color in the
Benedicts solution was blue (in glucose absence) to yellow, then orange and finally red
progressively with increase in the glucose levels. The used Benedict's solution was discarded into
the reserved waste vessel.
RESULTS
Post–Prandial Samples
These were the results that were recorded through the experiment which was done using post–
prandial the samples. It took 26 minutes for the sample taken from the Hepatic Portal Vein to turn
from the original blue color to yellow, which then changed

Use Of Pharmacological Thromboprophylaxis Into Medical...
Use of Pharmacological Thromboprophylaxis to Prevent Deep Vein Thrombosis in Medical–
Surgical Patients: A Review of Current Literature
Introduction:
Venous thromboembolism (VTE) has become a major health concern with 300,000–600,000 of
cases in the United States annually and contributes to a significant number of avoidable inpatient
costs (C. Dooley, 2013). Venous thromboembolism is also cited as the leading cause of preventable
in–patient deaths (Dooley, 2013). Research has indicated that post–operative patients on medical
surgical units have a 13–31% risk of deep vein thrombosis without interventions using prophylactic
antithrombotic therapy (Alhazzani et al., 2013). Deep vein thrombosis (DVT) is a common, yet
preventable postoperative ... Show more content on Helpwriting.net ...
Quality and Safety Education for Nursing (QSEN): In the nursing field, quality improvement is at
the forefront of evidence–based practice. To improve the quality of patient outcomes post
operatively, there must be implementation of evidence–based practice within the medical–surgical
population to reduce the incidence of venous thromboembolism and deep vein thrombosis and
promote patient safety. Evidence–based practice is defined by the Quality and Safety Education of
Nursing (QSEN) project as the integration of "best current evidence with clinical expertise and
patient/family preferences and values for delivery of optimal health care" (QSEN, 2014). This paper
will examine the current available research on venous thromboembolism prophylaxis in the
prevention of deep vein thrombosis in medical surgical patients by determining the best practice and
examining how it is implemented in the clinical setting to improve quality and safety for patients
within the healthcare setting (QSEN, 2014).
Overview of Venous Thromboembolisms & Deep vein thrombosis: To understand the use of
thromboprophylaxis in medical surgical patient to reduce the incidence of deep vein thrombosis, one
must first review the physiology related to the condition. Deep vein thrombosis occurs due to
occluded veins or stasis within the veins, which more frequently occurs within the lower extremities.
Venous return is often compromised because it goes against the flow of gravity and the

International Journal Of Advanced Research
Page 8
Page 9
15481546INR levels were less in PVT group than control group but in patients with early stages of
liver cirrhosis, no differences in their levels was found between the 2 groups. Therefore, patients
with advanced liver cirrhosis and less prolonged coagulation parameters appear to carry a higher
risk of PVT compared with patients with advanced liver cirrhosis and markedly prolonged
coagulation parameters. These findings were also reported by Weber et al. (19)in their study on
cirrhotic patients with PVT. The platelet levels were also lower with advanced stages of liver disease
possibly from hypersplenism, immune mechanisms and/or decreased production of thrombopoietin
synthesis in the liver (23).Our study demonstrated that platelet count inversely proportionate with
degree of liver decompensation. In patients with Child 's class C, the decrease in platelet count in
PVT group was less than that of control group. These results werein agreement with Francoz et al.
(24)and Donglei et al. (21)who reported that cirrhotic patients with PVT had higher platelet level in
comparison with cirrhotic patients without PVT and advanced stages of liver disease. From the
previous results we can conclude that, in cirrhotic patients the impact of portal hypertension and
deficiency of natural

Antagonistic Hormone Research Paper
Isabelle Bridges
Mr. Warnick
A&P 2nd period
5 September 2017
Antagonistic Hormones: Insulin and Glucagon
Insulin and glucagon are vital hormones in every human's body. Before studying how these
hormones relate and work together, what they are must first be determined. An antagonistic
hormone is a type of hormone that acts to return body conditions back to the acceptable limits from
opposite extremes ("Antagonistic Hormones"). Insulin is a hormone that tells cells throughout the
body to take in glucose from the bloodstream, and glucagon is a hormone that works to balance the
actions of insulin; they are antagonistic hormones (Morris). In this paper, the correlation between
these hormones will be examined, how they benefit the body, and what ... Show more content on
Helpwriting.net ...
Insulin and glucagon are essential to a normal life, and most people take this daily exchange of
hormones for granted. When examining anything in science, it is very important to always take a
look at who created everything, and who put these hormones and feedback loops into place. In
Isaiah 40: 29, it states, "He giveth power to the faint; and to them that have no might he increaseth
strength," It is very important that people, especially Christians remember to be grateful for their
health. Even if someone is not in the normal condition of health, as stated in Isaiah, God will still
give power and

Characteristics Of A Nurse
The Oxford English Dictionary defines a nurse as, "A person trained to care for the sick or infirm,
especially in a hospital." However, this is not my definition of a nurse. My idea of a nurse relates to
a superhero, aiding in the healing of a body. A nurse is a champion who comes into work with
energy, patience, aching feet, stained scrubs with sweat from a strenuous day at work but always a
smile. A nurse goes home 12 hours later from their shift only to remember the extra blanket for Jody
and also that is not sweat on my clothing, it is urine, but a nurse is thrilled that Phil finally went to
restroom after a ten–minute story about 10 cent candies. Not just any person could care for Jody,
who requests three blankets each night or Phil who refuses to utilize the restroom, but a superhero
could, a nurse could. I yearn to be a nurse; to be a superhero. Two exceptional qualities come to
mind when I regard a nurse, kindness and patience. Kindness for Jody, who will wake up in two
hours requesting less blankets because she is too hot, despite the fact this is a repeat of the exact
events from the day before. Patience for Phil for the reason that you told him he should try to visit
the restroom before dinner, but before long and he is explaining how to build a computer. Two
exceptional qualities I claim to express, every time I am on the job. My employment is in a long–
term care facility as a Certified Nursing Assistant, every day is a new adventure; maybe today I can

Venous Thrombosis
Venous thrombosis is a multifactorial disease. In the majority of thrombosis patients a risk factor is
not detectable. Virchow's triad refers to three primary influences for thrombus formation, endothelial
injury, stasis, turbulence or abnormal blood flow, and blood hypercoagulability (Kyrle, 2009). A
shift in balance between procoagulant and anticoagulant of the endothelium is responsible for
thrombotic state (Kyrle, 2009). Endothelial injury is the physical loss of endothelium leading to
exposure of subendothelial extra–cellular matrix, adhesion of platelets, release of tissue factor,
depletion of PGI2 and plasminogen activators (Kumar, 2010). Abnormal blood flow refers to
turbulence that causes endothelial injury, which is a major influence ... Show more content on
Helpwriting.net ...
Based on the ventilation perfusion scan, the patient reveals a high probability of pulmonary
embolus. Lack of fever indicates that the patient is not responding to inflammation or fever. The
patient should be asked about prothrombotic conditions which include pregnancy, cancer,
immobility, injury, surgery, smoking, diabetes, obesity, sickle cell thalassemia disease, heart failure,
renal failure, elevated cholesterol level, polycythemia vera, heparin use, and estrogen use (Kyrle,
2009). An irregularly irregular pulse indicates atrial fibrillation, which is a risk factor for thrombotic
stroke and may be an indicator of hyperthyroidism (Kumar, 2010). The patient is tachycardic with a
pulse of 110. Lung rales may be heard in patients with heart failure. The patient also presented with
a respiratory rate of 20/min although no mention of audible rales mentioned. Pedal edema may be
seen in heart failure and renal failure. The family history of her father dying of pulmonary embolism
is an important factor contributing to treatment for hypercoagulation. Assess liver and spleen size
palpating for masses or tenderness (Kyrle, 2009). Also assess for recent surgery and signs of trauma
or thrombophlebitis (Porth, 2015). Recommended tests for patients with suspected hypercoagulable
consist of CBC, lipid profiles, and TSH test (Kumar, 2010). A hypercoagulation panel and D–dimer
test are needed for monitoring anticoagulant therapy (Kumar, 2010). CBC results will reveal an
increase in RBCs. Elevated platelet counts could indicate thrombocytosis or a reaction to an
inflammation or infection. Low platelet count indicates idiopathic thrombocytopenia (Kumar, 2010).
The chemistry profile will show elevated glucose levels in patients with diabetes and elevated BUN
and creatinine in patients with renal failure (Kumar, 2010). A lipid profile may indicate

Portal Vein Thrombosis On Patients With Liver Cirrhosis
Portal vein thrombosis in patients with liver cirrhosis: insights to risk factors, clinical presentation
and outcome
Afifi F. Afifi 1, Osama M. Basha 1 , Fady M. Wadea 1, Abdelaziz E. Samack 2, Raghda Abd–elatif
Hafez 3
1– GIT and hepatology unit, Internal Medicine department, Faculty of Medicine, Zagazig
University.
2– Radiology department, Faculty of Medicine, Zagazig University.
3– Microbiology&Immunology department, Faculty of Medicine, Zagazig University. EGYPT
Manuscript Info Abstract
Manuscript History: Received: 14 October 2015 Final Accepted: 22 November 2015 Published
Online: December 2015 Key words: Portal vein, Thrombosis, risk factors, cirrhosis. *Corresponding
Author
Pawan Kumar Thakur
Background and objectives: Portal vein thrombosis (PVT) is an increasingly recognized
complication of liver cirrhosis. It is associated with worsening liver function, ascites and the
occurrence of gastroesophageal variceal bleeding. The aim of this work was to clarify the risk
factors, clinical presentation and complications of portal vein thrombosis in Egyptian patients with
liver cirrhosis and to study the outcome with and without treatment after 6 months follow up period.
Methods: Hospitalized cirrhotic patients (N = 80) were segregated into the PVT and non–PVT
groups. PVT was detected by Doppler ultrasonography; each group was divided in two sub groups
(A and B) according to presence or absence of HCC respectively. The 2 groups were compared as
regards risk factors,

SCD Compliance
Change is a hard concept for most, but change in the hospital setting can be beneficial for both staff
and patients. According to Mclean (2011), "Every change begins with an ending" (p.79). How
people respond to change can make the process easy or hard depending on how the change is
presented.
Sequential Compression Devices (SCD's) mechanically replace normal muscle motion in the leg via
a cuff that inflates and deflates uniformly. This mechanical inflation and deflation keeps blood
flowing in the veins and prevents the formation of clots that can result in deep vein thrombosis
(DVT) or pulmonary embolism. SCD's are used as prophylaxis in patient groups with low to
moderate risk of DVT (Brady et al., 2007, p. 256). Patient compliance ... Show more content on
Helpwriting.net ...
Studies to show which type of leg compression device is optimal for DVT prevention are not
available. Knee–length SCD's are more comfortable to patients, encourages higher levels of
compliance and also provide beneficial prophylaxis against DVT.
An informal survey of perioperative nurses, physicians and patients was performed regarding the
use of thigh–length versus knee–length SCD's. The surgical services management team, clinical
nurse educator, surgeons, and materials management were also involved in the process of using only
knee–length SCD's on all surgical patients. The surgeons, staff, and patients were perceptive and
willing to use only knee–length SCD's. The perioperative nurses were hesitant at times to call the
physician for an order to place knee–length SCD's on the surgical patient. This was a barrier to the
suggested change project.
Havelock's model of change will be used for this project. Perception of need, diagnosis of the
problem, identification of the problem, devising a plan of action, gaining acceptance of the plan,
stabilization, and self–renewal are all steps included in Havelock's model of change (Kearney–
Nunnery, 2012). Leadership is also an important part of the change process. In order to have a
positive outcome, the leader must incorporate the staff in the change process.
Providing clarity about the change can improve the transition process. According to Mclean (2011),
leaders

Portal Vein Thrombosis Case Study
This case study examines the development of Portal Vein Thrombosis ("PVT") in two patients,
M.W. and R.C., diagnosed with adenocarcinoma of the pancreas. In both cases the patients had low
volume local disease which responded to treatment over time. Both experienced a longer survival
length than typical pancreatic cancer patients, but ultimately experienced thombosis of the portal
vein and the superior mesenteric vein. Extrinsic compression of the celiac axis by the tumor further
exacerbated the disease. Both patients died as a result of liver failure caused by PVT. New research
in this field gives additional insight into prevention, diagnosis, and recognition of this disease. To
prevent PVT, low–molecular weight heparin administration reduces ... Show more content on
Helpwriting.net ...
PVT is a partial or complete thrombosis within the portal vein or its immediate downstream
tributaries. Light symptoms such as fatigue, mild swelling, and abdominal discomfort are the first
signs of PVT and are easily overlooked, or attributed to symptoms of cancer or cancer treatment. It
can also be nearly asymptomatic until the disease has progressed for a long time. Eventually,
symptoms such as ascites, hepatomegaly, and varices present. Varices can rupture and bleed,
resulting in potentially life–threatening complications. Additionally, due to a lack of nutrients being
delivered to the liver, PVT can cause liver failure. If the disease progresses further, death can
result7.
Although the medical community has known about hypercoagulation and its relation to cancer for a
century and a half, patients still die as a result of thromboembolism during cancer treatment. PVT
specifically is a near silent killer and is not well understood. More research is needed to combat
PVT and other forms of venous thromboembolism during

Deep Vein Thrombosis Research Paper
Deep vein thrombosis (also known as "DVT") occurs when a blood clot (thrombus) forms in one or
more of the deep veins in the body, however usually it often occurs in the legs. The most common
symptom is leg pain or swelling, but it can also occur without any symptoms. Sometimes certain
medical conditions can affect the development of DVT, especially if the condition has to do with
how the blood clots. Another way DVT can come about is if someone does not move for a long
time, such as a patient who is be confined to a hospital bed. Deep vein thrombosis is very serious
because blood clots in the veins can break loose, travel through the blood stream, and possibly lodge
into the lungs, which in turn blocks the blood flow causing a possible pulmonary embolism. When
diagnosing a lower extremity deep vein thrombosis on a patient, ultrasound is rated number one out
of the various diagnostic imaging modalities. MRI and CT are tied for the second highest rating ...
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If the ultrasound has findings, or if there are clinical symptoms that suggest proximal disease
(iliocaval), then an x–ray venogram of the pelvis may be performed. However, it is not the method
of choice. This is beneficial though because compared to CT, it uses a significant less amount of
radiation. It still uses radiation, but not as much. The lowest rating in the rankings is x–ray
venography of the lower extremity. This exam is generally used in conjunction with thrombolysis.
Thrombolysis is a treatment to dissolve dangerous clots in the blood vessels to improve blood flow
and prevent damage to the tissues and organs. It may involve the injection of clot–busting drugs
through an intravenous line or through a long catheter that delivers drugs directly to the site of the
blockage. These types of exams are not as common as the use of an MRI or CT machine may be
because of the severity of a

May-Thurner Syndrome: A Case Study
Iliac vein compression syndrome: clinical, imaging and pathologic findings
Abstract
May–Thurner syndrome (MTS) is the pathologic compression of the left common iliac vein by the
right common iliac artery, resulting in left lower extremity pain, swelling, and deep venous
thrombosis. Though this syndrome was first described in 1851, there are currently no standardized
criteria to establish the diagnosis of MTS. Since MTS is treated by a wide array of specialties,
including interventional radiology, vascular surgery, cardiology, and vascular medicine, the need for
an established diagnostic criterion is imperative in order to reduce misdiagnosis and inappropriate
treatment. Although MTS has historically been diagnosed by the presence of pathologic ... Show
more content on Helpwriting.net ...
utilized IVUS to confirm a diagnosis of MTS in 36 out of 58 patients; (62.1%) and defined the
IVUS criteria for an MTS diagnosis as the lack of an evident venous lumen proximate to the IVUS
catheter.[6] In a small scale study conducted by Forauer et al., IVUS was not only used to confirm a
diagnosis of MTS in all patients (n=16), but information provided by the study was also found to
influence the endovascular management of approximately 50% of the cases while also assisting with
stent placement choice and accuracy.[10] Moreover, in some studies, IVUS was found to have a
higher success than venography in identifying obstructions.[27–29] Overall, IVUS is a useful
modality in the diagnosis of MTS, although more studies are needed to truly evaluate its advantages
over other diagnostic

Deep Vein Thrombosis Case Study
Deep Vein Thrombosis (DVT) is a serious medical condition that affects certain hospitalized
patients. The healthcare team, especially the registered nurse, must understand what this condition
entails, who it affects, and how to prevent and treat this condition. The proper knowledge and
training will allow the registered nurse to be able to keep the patients safe and help prevent
complication from deep vein thrombosis.
A DVT is a blood clot that can occur anywhere in the body, but these blood clots tend to occur in the
deep veins of the legs and thighs. It is critical that these clots are diagnosed and treated promptly to
prevent further complications such as a pulmonary embolism, which occurs when a blood clot
travels from the lower extremities ... Show more content on Helpwriting.net ...
The registered nurse must be observant of any clinical signs that require further assessment such as
the signs and symptoms stated earlier in this paper. Previously, nurses were taught to use the
Homan's sign to assess for a DVT. After extensive research, it has been found that the Homan's sign
is not as effective as previously documented. Therefore, after additional research, the registered
nurse can use the Wells model when assessing a patient for a DVT. The Wells model is a numerical
scale similar to other scales used within the nursing practice and consists of a scoring system that
predicts the likelihood of a DVT. The Wells model assesses for the following criteria: if a patient has
active cancer, any paralysis, if the patient has been bedridden for more than 3 days or had a major
surgery within the last 4 weeks, Is the patient experiencing any local tenderness, any swelling or
pitting edema in the leg or calf, or is there an alternative diagnosis that is more likely than a DVT.
These areas are scored with a number 1 if positive and a 0 if negative. A score of 3 or more would
indicate a high probability for a DVT. A score of 1 or 2 would indicate a moderate probability, and a
score of 0 would indicate a low probability of a DVT. When doing an assessment, the registered
nurse can quickly use the Wells model to determine if further assessment is

Peripheral Vascular Disease Research Paper
What You Need to Know About Peripheral Vascular Disease
Peripheral vascular disease (PVD) is a type of circulatory disorder that affects blood vessels in areas
other than the heart or brain. Blood vessels that carry blood from the heart to the legs are most
commonly affected. Blood vessels in the arms, kidneys, and stomach are also commonly affected.
PVD is sometimes called peripheral arterial disease (PAD).
There are two types of PVD:
Organic PVD. This is the more common type. It is caused by damage to the structure of blood
vessels. This can result when fat, cholesterol, and other substances (plaque) build up in the blood
and narrow the arteries that carry blood to other areas of the body (atherosclerosis).
Functional PVD. This ... Show more content on Helpwriting.net ...
Pain and increased risk of infection in areas of the body with poor blood flow.
Tissue death in areas with poor blood flow (gangrene). Surgery to remove these areas of dead tissue
(amputation) may be necessary.
PVD also increases your risk of serious health problems, including:
Stroke.
A "warning stroke" that causes stroke–like symptoms (transient ischemic attack or TIA).
Heart disease.
Heart attack.
WHAT STEPS CAN I TAKE TO PREVENT PERIPHERAL VASCULAR DISEASE? Your daily
lifestyle habits can affect your risk of PVD. To lower your risk:
Do not use any products that contain nicotine or tobacco, such as cigarettes and e–cigarettes. If you
need help quitting, ask your health care provider.
Avoid drinking alcohol.
Maintain a healthy body weight.
Get regular exercise as directed by your health care provider.
Eat a heart–healthy diet. Choose low–fat, low–sodium foods and eat plenty of whole grains, fruits,
and vegetables.
It is also important to manage any long–term (chronic) health conditions you have that can increase
your risk of PVD. These include:
Diabetes.
Heart disease.
High blood pressure.
High

Evaluation Of A Improvement Plan
Improvement plan must be in place in order to decrease the likelihood of a reoccurrence of the
outcome of the Mr. B scenario. The model for Improvement gives us the foundation and the frame
work for doing improvement work. It is structured around several key components. There are 3
questions that are presented on this model. First question is what is your aim? We have also ask
ourselves how good we want to be and by when we will like to achieve it. Second question is how
would you know a change is an improvement? Which gets to measurements, we want to look at
process and outcome measures. The third question is what changes can we put in place to achieve
the aim? What change we can put into place that you can tract with data and you can match back up
against your aim (Lloyd, 2009).
B.) The improvement plan gets carried out with daily work with a team through the PDSA cycle.
The PDSA cycle stands for Plan, DO, Study, and Act. The PDSA is where we do testing on data to
day. We take the idea and place it in the PDSA cycle, where we plan it, do it, study it, and then we
act. We change the plan base on the feedback we get in the study step (Lloyd, 2009). In regard to
Mr. B's scenario, the aim of the improvement plan is to screen each patient that comes come to the
emergency room for Deep Vein Thrombosis (DVT). We will have a DVT flowchart available to the
nurse to use to ask each patient question that may be related to signs and symptoms of DVT. We can
also have standing

Statistical Methods Of Data Management And Statistical...
Statistical Methods
Data management and statistical analysis by SPSS software version 13 was used. Baseline
laboratory markers were expressed as mean ± standard deviation (SD) or standard of error (SE)
when appropriate. Progression free survival and overall survival were analysed by the Kaplan–
Meier method. Paired t test was used to compare AFP, size and number of focal lesions after therapy.
ANOVA test was used when appropriate, P< 0.05 indicating statistically significance result. Results
The baseline characteristics of 15 patients were shown in table 1. 4 patients had one focal lesion
(26.7%), 3 patients had 2 focal lesions (20%), 5 patients had 3 focal lesions (33.3%), 3 patients had
four focal lesions (20%). 11 patients had portal vein thrombosis (73.3%). The mean of the sum of
tumoral size in its longitudinal diameter is 10.5 ± 4.1 cm, mean Child Turcotte Pugh score was 6.33
± 0.3, MELD score 13.7±1.4, PS < 2. The patients were given the planned medications and followed
up after 1 month with AFP level, abdominal USG and triphasic CT to detect the number and size of
lesions. During therapy, 6 patients developed rising bilirubin (40%) to grade 3 which improved after
adding ursodeoxycholic acid, worsening thrombocytopenia in 4 patients (26.7%), melena in 2
patients (13.3%) which were improved with temporary cessation of therapy. Hand and foot
syndrome in 3 patients (20%).
After one month of therapy as shown in table 2; a highly significant reduction in size of lesions

Questions On The Practice At A Semester II Level
Current review for VTE prophylaxis
Shubhreet Malhi
300192775
Table of Contents
Introduction.....................................................................................................3
Analysis and Synthesis.......................................................................................4
Implications to the practice at a semester II level.........................................................6
Impact on the nursing care and or health care.............................................................8
Conclusion....................................................................................................10
References.....................................................................................................11
Appendix A: Matrix Table...................................................................................3
Current review of VTE prophylaxis
INTRODUCTION
Throughout the surgery, numerous complications arise despite the proper planning. Perhaps, one of
the most dangerous complication is the Venous Thromboembolism (VTE) – a broad concept which
encompasses Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). The risk for VTE after
surgery is further increased and in absence of thromboprophylaxis, it is associated with high
mortality rate of 40–60% (Liu et al., 2016). Hence, VTE prophylaxis guidelines recommends the use
of pharmacological prophylaxis such as warfarin, low molecular weight heparin (LMWH).
However, the chemical therapeutic agents are associated with increased risk of bleeding,
intraoperative hemorrhage and hematoma (Frostick, 2016). This further results in delayed wound
healing, infection and high risk of readmission (Nam et al., 2015). Therefore, this paper explores is
the cooperative effectiveness of mechanical prophylaxis such as mobile Compression Devices

Risk Factors, Clinical Presentation And Outcome
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Portal vein thrombosis in patients with liver cirrhosis: insights to risk factors, clinical presentation
and outcome
Article in International Journal of Advanced Research 3(12):1539–1548 · December 2015
1st Afifi F Afifi
2nd Osama Basha
6.99 · Zagazig University
+ 1
3rd Fady Maher
Zagazig University
Last Raghda Abd Ellatif Hafez
16.2 · Faculty of medicine/Zagazig University.www.zu.edu.eg
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Page 1
15481539Journal homepage:http://www.journalijar.comINTERNATIONAL JOURNALOF
ADVANCED RESEARCHRESEARCH ARTICLEPortal vein thrombosis in patients with liver
cirrhosis:insights to risk factors, clinical presentation and outcomeAfifi F. Afifi 1, Osama M. Basha
1, Fady M. Wadea 1, Abdelaziz E. Samack 2, Raghda Abd–elatif Hafez31–GIT and hepatology unit,

Internal Medicine department, Faculty of Medicine, Zagazig University.2–Radiology department,
Faculty of Medicine, Zagazig University.3–Microbiology&Immunologydepartment, Faculty of
Medicine, Zagazig University. EGYPTManuscriptInfoAbstract Manuscript History:Received:14
October 2015Final Accepted: 22 November 2015Published Online: December 2015Key words:
Portal vein,

Lovenox Research Paper
Your medication Lovenox is the brand name for Enoxaparin, a blood thinning or anticoagulant drug,
given to prevent and treat blood clots in a number of clinical situations, but primarily, like in your
situation, to treat deep venous thrombosis or DVT. As you might not know, this drug is produced by
chemically breaking down heparin (natural compound, which inhibits blood clotting) into smaller
molecules, and it works by blocking the actions of Factor X and Factor II, which are two of the
twelve clot–promoting proteins in blood.
Additionally, as you already might learn from your experience, DVT is a blood clot that develops in
deep veins, usually in the lower leg. It could be dangerous because the clot may become large, or it
could break in

Hepatic Portal Vein Obstruction ( Ehpvo )
Introduction: Extra–hepatic portal vein obstruction (EHPVO), i.e., in the absence of liver cirrhosis
or abdominal cancer, is a rare manifestation of venous thrombosis that often leads to portal
hypertension1.After prothrombin, factor V, next most common cause of thrombophilia is high
plasma levels of coagulation factor VIII, which are present in approximately 20% of patients with
deep vein thrombosis (DVT) of the lower limbs and increase the risk of the disease in a dose–
dependent manner 2. Like fibrinogen, factor VIII is an acute phase reactant whose concentration
rises in plasma in the presence of inflammation. However, high factor VIII levels are associated with
an increased risk of DVT independently of the acute phase reaction3.
Case report: A 21–year–old male in good health and with no significant past medical history
presented with abdominal pain for 2 months in epigastric and left hypochondrium. He is not on any
drugs. History of similar complaints in his younger sister and she died 2 years back without any
evaluation. A contrast enhanced computed tomography scan of the abdomen showed superior
mesenteric vein thrombosis with multiple collaterals in perigastric and porta hepatis. A coagulation
profile work–up was done. His factor VIII activity concentration was found to be 260% of normal
(normal: 60–150). Analyses for prothrombin O20210A

Portal Vein Thrombosis On Patients With Liver
1548
1539
Journal homepage: http://www.journalijar.com INTERNATIONAL JOURNAL OF ADVANCED
RESEARCH RESEARCH ARTICLE
Portal vein thrombosis in patients with liver cirrhosis Insights to risk factors, clinical presentation
and outcome
Afifi F. Afifi 1
, Usama M. Basha 1
, Fady M. Wadea 1
, Abdelaziz E. Samack 2
, Raghda A. Elsherbini 3
1– GIT and hepatology unit, internal medicine department, faculty of medicine, zagazig university.
2– radiology department, faculty of medicine, zagazig university.
3– clinical pathology department, faculty of medicine, zagazig university. EGYPT
Manuscript Info Abstract
Manuscript History:
Received: xxxxxxx
Final Accepted: xxxxxxxxxxxxxx
Published Online: xxxxxxxxxxxx
Key words:
Portal vein, Thrombosis, risk factors, cirrhosis.
*Corresponding Author
Pawan Kumar Thakur
Background and objectives: Portal vein thrombosis (PVT) is an increasingly recognized
complication of liver cirrhosis. It is associated with worsening liver function, ascites and the
occurrence of gastroesophageal variceal bleeding. The aim of this work was to clarify the risk
factors, clinical presentation and complications of portal vein thrombosis in patients with liver
cirrhosis and to study the outcome with or without treatment after
6 months follow up.
Methods: Hospitalized cirrhotic patients (N = 80) were segregated into the
PVT and non–PVT groups. PVT was detected by

Splenectomy: A Case Study
The article I chose to review regarding my patient's diagnosis discussed several studies looking at
the effects of splenectomy on liver volume and function, and prognosis of cirrhosis in patients with
esophageal varices. These studies were quite interesting considering my patient's history of
splenectomy, liver cirrhosis, and esophageal varices. Changes in hepatic function, splenic function,
and liver volume were evaluated, as well as each patient's probability of increased survival rate.
Results showed that restoration of liver function accelerated over time once a splenectomy had been
performed. No patient in the studies had any serious complications, such as severe infection as a
result of splenectomy. The two groups showed no significant

Doppler Ultrasound
Careful follow up and consistent monitoring are essential to ensure proper function of the
portosystemic stent. While portal venography is excellent at demonstrating stent patency, Doppler
ultrasound allows visualization of blood flow within the stent, portal system and hepatic venous
system without the need for radiation and contrast injections. According to Boyer,23 TIPS
dysfunction occurs in about 80% of treated patients. He suggests using Doppler ultrasound to assess
the stent within 24 hours of placement. Regular follow up Doppler studies should be performed
every three months to ensure patency of the stent and to assess for recurrent portal hypertension. If
symptoms of portal hypertension persist after TIPS or increase, Fidelman et al,23 ... Show more
content on Helpwriting.net ...
Manipulating the transducer to obtain an optimal angle of incidence is important. Sub–xiphoid,
subcostal and intercostal views are all potentially used to align the beam with the vessel of interest.
Stent material is easily seen using two–dimensional ultrasound. "Shadowing is only a problem when
stents covered with fabric such as polytetrafluoroethylene are used. In these cases, gas that is
embedded in the fabric will cause shadowing for several days, but eventually the gas is absorbed
and the covered stents then appear similar to conventional stents."8 Middleton, Teefey and Darcy8
note that the use of PFTE endografts will likely become standard as their performance outweighs the
early stent materials used. Color Doppler as well as pulsed Doppler should be used to interrogate the
stent and supporting vessels. Velocity measurements are taken using angle correct and spectral
waveforms are recorded. Careful examination of the liver vasculature is imperative to verify proper
stent function. Specifically, thrombosis or occlusion can be assessed with color and Doppler
ultrasound. Velocity parameters may vary from patient to patient and also will change from
immediate post procedure velocities to those obtained during long term follow up. Universal
Doppler criteria has not been established as of yet, although some physicians and facilities have
developed

Venous Thromboembolism And Pulmonary Embolism
Venous Thromboembolism
Venous thromboembolism (VTE), including both deep venous thrombosis (DVT) and pulmonary
embolism (PE), is reognised as the leading cause of preventable in–hospital mortality. DVT is the
formation of blood clots in a deep vein– usually the large veins in the leg or pelvis. The most serious
complication of a DVT is that the clot could dislodge and travel to the lungs, becoming a life–
threatening blood clot in the lungs, pulmonary embolism. When a blood clot breaks loose and
travels in the blood, this is called a venous thromboembolism. An inflammatory reaction is usually
present mainly in the superficial veins and, for this reason this pathology is often called
thrombophlebitis. It is a disorder that can occur in all races and ethnicities, all age groups, and both
genders. Despite a marked increase in federal and national efforts to raise awareness and
acknowledge the need for VTE prevention, VTE continues to remain as an important and growing
public health problem. Unfortunately, VTE recurs frequently and is commonly overlooked, affects
both hospitalized and non–hospitalized patients, and results in long–term complications including
chronic thromboembolic pulmonary hypertension (CTPH) and the post–thrombotic syndrome
(PTS).
Venous thrombi, composed predominately of red blood cells but also platelets and leukocytes bound
together by fibrin, form in sites of vessel damage and areas of stagnant blood flow such as the valve
pockets of the deep veins of

Patients With A Deep Vein Thrombosis Essay
Clinical Question: In patients with a deep vein thrombosis, how does early ambulation compared to
best rest affect the incidence of worsening DVT or development of a pulmonary embolism?
3. Search Methods
When conducting a research paper, it is important to keep record of what databases and search
criteria being used. For our research specifically, we went through the online database access from
the UNH library site and focused on using EBSCO as our database searched. Key words included
within the searches include: Deep Vein Thrombosis, ambulation, bedrest, treatment, and
management. The goal of this conducted search was to find a sufficient amount of articles that
pertained to our topic which were written in the last 10 years and were English only. Of the many
available articles, we then briefly scanned through each one to extract the articles which fully
pertained to our topic, rather than having articles which just casually mentioned the topic. This was
the only criteria which would determine whether the article would be included or excluded, however
the criteria worked for this situation as the end result. In the end, five articles were included in our
research of our clinical question, each focusing the article around ambulation with a Deep Vein
Thrombosis.
4. Critical Appraisal of the Evidence.
Anderson study: Four randomized trials of patients, aged 52–66, with DVTs were done to determine
different interventions that can contribute to either making DVT's

Portal Vein Thrombosis, Risk Factors, Cirrhosis
Abstract
Manuscript History: Received: 14 October 2015 Final Accepted: 22 November 2015 Published
Online: December 2015 Key words: Portal vein, Thrombosis, risk factors, cirrhosis. *Corresponding
Author
Pawan Kumar Thakur Background and objectives: Portal vein thrombosis (PVT) is an increasingly
recognized complication of liver cirrhosis. It is associated with worsening liver function, ascites and
the occurrence of gastroesophageal variceal bleeding. The aim of this work was to clarify the risk
factors, clinical presentation and complications of portal vein thrombosis in Egyptian patients with
liver cirrhosis and to study the outcome with and without treatment after 6 months follow up period.
Methods: Hospitalized cirrhotic patients (N = 80) were segregated into the PVT and non–PVT
groups. PVT was detected by Doppler ultrasonography; each group was divided in two sub groups
(A and B) according to presence or absence of HCC respectively. The 2 groups were compared as
regards risk factors, clinical presentation and complications. The outcome of treatment with
anticoagulation in 6 patients was evaluated. Result: PVT developed as result of combination of both
local and systemic risk factors. HCC, abdominal infection especially spontaneous bacterial
peritonitis and abdominal intervention were the most important local risk factors. Abnormalities of
coagulation system were among systemic risk factors. Most of cases were asymptomatic and
accidentally discovered, others presented

Chronic Venous Insufficiency: The Pooling Of Blood
Chronic venous insufficiency (CVI) typically results from having varicose veins in which pooling of
blood in a vein occurs. With varicose veins, the veins are unable to do their job of preventing
backflow with their valves, thus causing a pooling of blood. Those affected with varicose veins
progress into having CVI. CVI is when, over an extraneous period of time, venous return is not
adequate enough. Simply, CVI affects a person when the valves of the veins in their lower
extremities are no longer keeping blood from flowing backwards. This also explains as to why
varicose veins leads to CVI, as varicose veins is the pooling of blood. CVI can be caused by a blood
clot in the vein, or otherwise known as deep vein thrombosis (DVT), which damages

Venous Tromboembolism: A Case Study
Venous thromboembolism (VTE) is the formation of a blood clot that causes some life–threatening
conditions such as deep vein thrombosis (DVT), pulmonary embolism (PE), and post–thrombotic
syndrome (Hillegass et al., 2016). The risk of developing DVT in patients after surgery ranges
between 20–30% and PE ranges between 0.2–0.9% (Soomro, Yousuf, Bhutto, Abro, & Mamon,
2014). Therefore, it is critical to identify the risk factors and initiate early thromboprophylactic
therapy to prevent VTE. While working in an orthopedic hospital I came across several cases with
clinically diagnosed DVT and PE.
Early mobility is the fundamental treatment to prevent VTE. After surgery such as knee
replacement, hip replacement or any other surgical treatment I used to get an approval from a
surgeon or skilled ... Show more content on Helpwriting.net ...
While taking regular physical assessment the therapist should be aware of the signs of DVT or PE
that include redness, warmth, or swelling. Additionally, DVT can be predicted from a few laboratory
tests such as International normalized ratio (INR), prothrombin time, and hemoglobin level. These
laboratory tests indicate blood clotting. Homan's sign is one of the tests to rule out DVT but it is not
reliable because of the low sensitivity and specificity, and the therapist should not be relied on it
(Goodman & Snyder, 2013). Doppler ultrasound is the most common noninvasive and painless test
for DVT. In the hospital where I was working, the treatment protocol to prevent DVT included
assisted walking and leg exercises as soon as possible after surgery. Leg exercises included static
quads and ankle, knee, and hip joint movements, not just to strengthen the lower extremity muscles
but also to improve blood circulation in the deep veins and avoid blood clotting. Continuous passive
movement

Embolism In Hospital Setting
It is not uncommon for death to occur in an unusual way in a hospital setting. One such occurrence
is frequently identified as a pulmonary embolism. The patient comes in with an initial diagnosis of
lung cancer with metastasis to the liver. She is expected to live for a few more days. To show
compassion, the nurse decides to give her a bath, change her linens, and help her become more
comfortable. After providing her with care, the patient has one more request, to get a leg massage.
Oblivious to any complications, the nurse proceeds to give the patient a good leg rub. Minutes later,
the patient is found unresponsive on the floor. The patient suffers from a venous thromboembolism
in one of her legs, that when massaged, travels all the way up ... Show more content on
Helpwriting.net ...
Anti–embolic stockings work by exerting graded circumferential pressure from distal to proximal
regions of the leg conforming to a Sigel pressure profile. These increase blood velocity, promote
venous return, and have shown to be effective (Barker, 2011). Intermittent pneumatic compression
periodically compresses the calf and thigh muscles, mimicking the muscle pump created by
walking, promoting fibrinolysis, and have shown to also be effective (Barker, 2011). Foot impulse
devices increase venous outflow and reduce stasis in immobilized patients. They also mimic
walking by compressing the plantar venous plexus, and they are effective after orthopedic surgery in
reducing asymptomatic DVT (Baker, 2011). Mechanical methods will most likely be used in
patients at high risk for bleeding. Physiotherapy and nursing has also been a method used by staff in
increasing the prevention of VTE. Risks can potentially be mediated by mechanical calf and foot
venous compression, bed exercise, active or passive, and early mobilization, and by hydration
(Barker,

Hlten503B Contribute to Client Assessment and Developing...
Implement and monitor nursing care for clients with acute health problems. Contribute to complex
nursing care of clients. Administer and monitor medications. Administer and monitor IV meds.
Assessment 2 Post–op Case Study Assessment 2 Question 1. Identify a minimum of 5 nursing
actions, in order of priority you would perform related to above information. Mrs Abu has had a
considerable change in her vital signs (blood pressure lowered, her pulse is rapid, her respirations
increased and temperature has dropped) form the baseline taken before surgery. These findings alone
would be reported to the Registered Nurse and monitored. But because of the changes in vital sings,
coupled with Mrs Abu reporting light–headedness and ... Show more content on Helpwriting.net ...
|Deceases the cross contamination to the | |surgical intervention | |client. | | |Use of aseptic technique
for wound |Reduces the risk of pathogens to the | | |dressings |surgical site. | | | |Any increased
redness, pain, and purulent| | |Monitor for signs of infection at wound |drainage and excaudate
should be | | |site. |cultured. | | | |These exercises reduce the secretions | | | |staying in the lungs and
bronchial tubes.| | |Encourage coughing and deep breathing |Any signs of yellow or yellow green | |
|exercises and monitor for signs of |sputum may indicate infection. | | |infection in respiratory

The Benefits of Preoperative Education
Patient education is a major concern in pre–operative patient care. Preoperative education can
improve patient satisfaction with the surgical experience. Typical patient education is provided
through leaflets that are given to the patient before surgery and verbal information given by both
doctors and nurses on the day of surgery. Pre–operative education is vital to patient comfort and
safety of the patient. Appropriate preparation can minimise anxiety and stress, and therefore many of
the physical effects, and ensure patients arrive in the operating theatre department ready for surgery.
Physical preparation usually consists of a complete medical history and physical exam, including the
patient's surgical background. The patient should inform the nursing staff if he or she has ever had
an adverse reaction to anesthesia (such as anaphylactic shock). Laboratory tests may include
complete blood count , and urinalysis . The patient may also have an electrocardiogram (EKG) if
they are over 50 years of age or if he or she has a history of cardiac disease . A chest x ray may be
done if a patient has a history of respiratory disease. Part of the preparation includes assessment for
risk factors, such as nutritional deficiencies, steroid , drug or alcohol abuse and metabolic diseases
such as diabetes as these may affect healing time. The patient should also provide a list of all
medications or food supplements that they use. Supplements are often overlooked, but may cause
adverse

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