Final answer:
The most appropriate VTE prophylaxis for the patient is likely Low molecular weight heparin (LMWH), due to the patient's high risk of VTE and recent surgery. Warfarin requires close monitoring and might not be suitable, while aspirin alone isn't typically enough for high-risk patients and compression stockings can only serve as an adjunctive measure. Pharmacogenomics can assist in tailored drug management, especially in the context of medications like warfarin.
Step-by-step explanation:
Based on your patient's risk assessment and medical history, the most appropriate venous thromboembolism (VTE) prophylaxis order would likely be 1) Low molecular weight heparin (LMWH). LMWH is frequently used in patients with a high risk of VTE due to its reliability, ease of use, and reduced need for monitoring compared to warfarin. Warfarin would require careful monitoring of INR levels, and given the patient's recent surgery and bleeding risks, it may not be ideal. Aspirin alone is not typically sufficient for VTE prophylaxis in high-risk patients. Compression stockings could be used as an adjunctive measure, but alone they may not provide adequate protection for someone at high risk of VTE. Pharmacogenomics could play a role in drug management by analyzing the patient's genetic profile to anticipate drug metabolism and efficacy, especially for drugs like warfarin, where genetic variations can impact dosing and risk of bleeding or thrombosis.
Heart failure increases DVT risk because the impaired pumping action of the heart can lead to slower circulation and stasis of blood, particularly in the lower extremities. This stasis can cause blood to pool and form clots. Walking and leg exercises improve venous return and can help mitigate this risk, which is why they are recommended during situations such as long flights when mobility is restricted.