Discuss the pathophysiology of a dvt

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Reference no: EM133482232

Assignment:

A 52-year-old female patient presents for follow-up 7 days after hospitalization for her first deep vein thrombosis (DVT) in the left leg. She is currently taking rivaroxaban (Xarelto) 15 mg once daily. She had thrombolysis while in hospital and reports a decrease in swelling and tenderness of left leg. She also is positive for Factor V Leiden. The patient is in today and asking why she is taking rivaroxaban and not warfarin (Coumadin) like some of her friends who had a similar problem. She also wants to know how long she should be on rivaroxaban.

Past Medical History- Patient also reports that she is asthmatic and hypertensive.

Allergies- None Known

Medications- Rivaroxaban 15 mg daily, HCTZ 25 mg daily, Advair 250/50 daily, Ibuprofen 400-

600 mg po prn

Physical Exam:

Weight: 160 lb Height: 65 in BMI: 26.6

BP: 160/92 Temp: 98 Pulse: 70 Resp: 18

Labs:

CBC: WBC: 10.2 HGB: 13 HCT: 40 PLT: 326

BMP: Glucose: 145 BUN: 28 Creat: 1.5 K: 3.9 CrCl 50 mL/min

LFT: AST: 35 ALT: 42 Alk Phos: 35

Questions

1. Discuss the pathophysiology of a DVT.

2. List the tests that should be included in a coagulation panel and briefly describe what the test measures and why each is needed.

3. Explain thrombolysis and why it was included in the original treatment of the DVT.

4. When completing the history and physical exam, what questions would you include in the review of the systems?

5. Write a detailed history and physical examination using the information from the case and findings you might expect from a person with a DVT. Complete this in the form of a SOAP note.

6. Discuss why rivaroxaban was selected, how it should be adjusted, any specific scheduled timing and any other considerations you believe are important. What changes, if any, would you make and why? Use current clinical guidelines and other scholarly articles to support your information.

7. How long should this patient remain on rivaroxaban and the rationale?

8. When considering the information provided, are the current medications appropriate? Why or why not?

9. Discuss a detailed treatment plan for this patient including patient education.

Reference no: EM133482232

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