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June 2011, Volume 41 Number 6 , p 72 - 72


  • Ellen Pfadt PhD(c), RN
  • Dorothy S. Carlson DEd, RN


Mr. O, 66, ARRIVES IN THE ED complaining of pain and swelling in his left leg. You assist him to a stretcher and assess both lower extremities. His left leg is erythematous and edematous, with a 4-cm difference between the left and right calf diameters. The left calf is also warm and tender to touch. Pedal pulses are 2+ bilaterally. You place Mr. O on a cardiac monitor. His vital signs are: temperature, 99.6[degrees] F (37.6[degrees] C); heart rate and rhythm, 106, sinus tachycardia; respirations, 20; SpO2, 96% on room air; and BP, 148/90. You elevate his left leg on pillows.Mr. O tells you he returned from Europe about a week ago and has smoked one pack of cigarettes a day for 40 years. He is also obese, with a BMI of 30. Otherwise, his medical and surgical history is unremarkable.Based on the patient's history, physical assessment findings, and a Wells score of 3 (high probability of deep vein thrombosis [DVT]), you suspect Mr. O has a left lower extremity DVT. Mr. O's risk factors include

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