RN Nursing · Peripheral Vascular Disorders · Practice question
A nurse is caring for a client who is postoperative following vascular surgery. Which of the following signs should indicate to the nurse that the client has developed a thrombus?
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Positive Homan's sign.
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Positive Kernig's sign.
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Soft, pliable calf muscle.
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✓
Dull, aching calf pain.
Answer & explanation
Correct: Dull, aching calf pain.
Following vascular surgery, deep vein thrombosis (DVT) is a serious complication. The classic clinical sign of a DVT in the lower extremity is dull, aching calf pain, often accompanied by warmth, redness, and swelling in the affected limb. This pain results from venous obstruction and inflammation of the vessel wall caused by the thrombus. Homans' sign — pain in the calf upon dorsiflexion of the foot — was historically taught as a sign of DVT; however, current evidence shows it has poor sensitivity and specificity and is not considered a reliable diagnostic indicator; its use is no longer recommended in clinical practice, making it an incorrect choice here. Kernig's sign is associated with meningeal irritation, not thrombosis, and is therefore unrelated. A soft, pliable calf muscle is a normal finding and does not suggest the presence of a thrombus. Dull, aching calf pain remains the most clinically relevant option among those provided for identifying a developing thrombus.
Study note
Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Nursing Study Guide
A comprehensive nursing study guide on DVT and PE, covering risk factors, clinical presentation, Wells scoring, diagnostics, anticoagulation therapy, nursing care, and NCLEX high-yield pearls.
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