VTE Prevention Questions

Venous thromboembolism, a clot forming in a vein and sometimes travelling to the lungs, is a major and largely preventable cause of harm in hospital. The CBT tests whether you can help prevent it and recognise it when it happens.

Assess first

Prevention starts with assessment. Every patient has a VTE risk assessment on admission, reviewed when their condition changes, weighing their clot risk against their bleeding risk. This is what decides the right prophylaxis, so the exam rewards assessment over a blanket approach. Waiting for symptoms, or leaving assessment to discharge, defeats the purpose.

Mechanical and drug prophylaxis

Prophylaxis comes in two forms. Mechanical measures include anti-embolism stockings and intermittent pneumatic compression. Drug measures usually mean prophylactic anticoagulation such as low molecular weight heparin. Both follow assessment, because both have contraindications. Stockings, for instance, are not for everyone: they are contraindicated in patients with significant peripheral arterial disease and must be correctly fitted, which is why they are not simply applied to every patient automatically.

Simple measures matter too. Early mobilisation and good hydration keep blood flowing and reduce clot risk, while prolonged bed rest and dehydration increase it. Getting patients safely moving is part of prevention, not a reward for recovery.

Recognising DVT and PE

Nurses also need to spot a clot that has formed. A deep vein thrombosis often causes swelling, pain, warmth and redness, usually in one calf or leg. A swollen, painful, warm calf after surgery is assessed promptly, not dismissed as a bruise. A pulmonary embolism, where a clot reaches the lungs, causes sudden breathlessness, chest pain and a fast heart rate, and is a medical emergency needing urgent escalation. Putting sudden breathlessness after immobility down to anxiety or indigestion is exactly the mistake these questions are built to catch. Next: falls prevention in practice. Five VTE scenarios first.