Nursing Case Study Vte

1. What are her risk factors for developing a VTE? (Identify all factors.)

Her risk factors for VTE are her 72 years of age, diagnose of cholangiocarcinoma, her recent post proximal bile duct open laparotomy, extended right hepatectomy with portal vein resection and reconstruction, radical bile duct resection, hepaticojejunostomy and cholecystectomy surgery, gemcitabine therapy, pain and leg swelling x 2 weeks, 15-pound weight gain, difficulty with breathing, feeling weak, debilitated and multiple falls; also her previous history of thrombosis. Her history of 3+ pitting edema in the bilateral lower extremities and her recent abdominal ultrasound revealing occlusive portal vein thrombosis also is a risk factor for Mrs. X’s VTE.
2. What are
Overlapping heparin or enoxaparin therapy is especially important in patients who have a much more risk factor to thrombotic events such as patient with protein C or S deficiency and also patient who metabolizes Coumadin more rapidly than the average person. (Heit et. al. 2011)
5. What are the indications which would trigger the need to evaluate a person for the presence of a hereditary thrombophilia?
A person presenting with DVT or pulmonary embolism, family history of thrombophilia are some of the indication that would trigger the need to evaluate for the presence of hereditary thrombophilia. (Schwartz & Rote, 2014)
Does Mrs. X need to be further evaluated for a hereditary thrombophilia? Why or why not?
Mrs. X definitely needs to be further evaluated for thrombophilia because she has a family history of cancer which she currently has; she has a history of thrombocytopenia and iron deficiency
Why does she have ascites and splenomegaly?
Mrs. X Ascites and splenomegaly are from the worsening cholangiocarcinoma and her recent surgical history. Mrs. X may need to be reevaluated for hepatocarcinoma given that her brother died from this at the age of