Week Four
NURS6531, N-8 As a nurse practitioner (NP) one must obtain a thorough history and physical of every patient to avoid a misdiagnosis, which can have dire consequences. For the purpose of this discussion, I will evaluate how two separate primary care providers missed a deep vein thrombosis in a patient. Also, I will state strategies for obtaining a patient history, ordering diagnostics, and recommending treatment options. In case study number two a 50-year-old Caucasian male presented to the emergency room (ER) complaining of right leg pain. The first provider brushed it off as muscle strain as the man was an avid runner. He prescribed Flexeril as needed and Motrin 800mg q8h as required for pain. A week later the gentleman went to his primary care provider (PCP) still suffering from pain. The PCP advised the patient to continue on the same regimen and stated that the pain would go away in five to ten days. Overnight the pain in his leg became worse. Therefore, he had to go to the ER the next day. Risk factors for deep vein thrombosis are an inherited blood-clotting disorder, injury or surgery, prolonged periods of inactivity, pregnancy, obesity, smoking, cancer, heart failure, inflammatory bowel disease, and age (Mayo Clinic, 2016). It is easy to misdiagnose blood clots as the …show more content…
An accurate diagnosis of a DVT is essential to avoid issues such as a pulmonary embolism (PE), which is life-threatening. With the suspicion of a DVT, one should move on to a venous ultrasound and a D-dimer assay. A D-dimer assay can exclude more than 25% of people with symptoms of a DVT, therefore, negating the need for further investigation (Kesieme, E., Kesieme, C., Jebbin, Irekpita, & Dongo, 2011). The clinical usefulness of the D-dimer decrease with age, but in this situation would have been a good idea since the patient is only