Question

	Assessment #2 CB: Perfusion Scenario
Purpose	To provide students with the opportunity to assess a patient who is experiencing pain, swelling, and warmth in her right calf.
Overview	Annie Laduke is a 32-year-old Native American female with no significant health history. This morning, she presented to her provider's office with complaints of pain, increased redness, and warmth of the right lower leg in the calf area. She was directly admitted to the inpatient medical unit by her provider.
Skill Review: Please review the following skills.	Peripheral Vascular Assessment
Pharmacology Review: Please review the following medications.	Ibuprofen
Questions 1: What objective and subjective data indicate that Annie Laduke may have thrombophlebitis?
Question 2: Describe how to test for Homan's sign. Identify the characteristics and implications of a positive and negative Homan's sign as well as any relevant precautions to consider when assessing for this sign.

Culture & Diversity
What sociocultural factors will influence your care of Miss Laduke?

Answer 1

1. Objective data that indicates that Annie have thrombophlebitis are :-

- redness in the calf

- swelling in the calf

Subjective data that indicates that Annie have thrombophlebitis are :-

- warmth

- pain

2. Homans sign - Test to detect DVT in the lower leg

#. Procedure :-

-Passively dorsiflex the foot at the ankle with the knees striaght

#. Interpretation

-homan's sign is positive for DVT if the maneuver produces pain in the calf or popliteal space

-clinical findings alone are insensitive and nonspecific and can't be relied on to confirm or exclude the diagnosis of DVT

-positive Homan's sign warrants further evaluation

3. Socio-cultural factors that may influence the care :-

Client's use of over-the-counter medications (observe for signs and symptoms of toxic medication levels, especially fat-soluble vitamins)

Nutritional assessments of dietary habits

Extensive exercise habits