Common reasons for venous disorders - Answer- incompetent valves (chronic)
obstruction of venous return to the heart due to thrombus (acute)
Venous thromboembolism - Answer- *deep vein thrombosis*
50% develop a PE as a complication
Virchow's Triad - Answer- 2 of the 3 must be present to have a thrombi form
DVT risk factors - Answer- 40 + years
women
major surgery in the past 3 months
trauma
long bone and pelvis fractures with casting
immobility for more than 3 days
prolonged sitting
recent travel on plane or in a car
dehydration
meds (oral contraceptives, estrogen, steroids, NSAIDs)
CHF, obesity, ulcerative colitis, active cancer
H/O clotting disorders
Preventing DVTs - Answer- sequential stockings (must wear 90% or the time)
early post-op ambulation
education
TEDs (not when DVT is present)
*do not massage calves*
ROM
Fluids
S/S of DVT - Answer- calf or groin tenderness
pain
unilateral edema of leg (calf circumference)
redness/warmth
tender. dilated veins, induration (hardening)
low grade fever
+Homan's sign
Venous Duplex Ultrasonography - Answer- vein mapping (noninvasive)
assess the flow of blood through the veins
Venogram - Answer- -uses DYE
--only done if absolutely necessary
-most accurate if other tests neg & DVT still suspected