Deep Vein Thrombosis Exam Graded A+

Deep Vein Thrombosis Exam Graded A+ What is the concept of deep vein thrombosis? - Answer- Perfusion Thrombophlebitis - Answer- A condition in which a blood clot in a vein causes inflammation and pain Typically happens in lower legs, or calves, but occasionally in the arms, neck, and chest What are the two types of thrombophlebitis? - Answer- •Superficial thrombophlebitis-blockage near skin surface *usually just annoying symptoms •Deep venous thrombosis (DVT)- thrombosis is located in a muscle *life threatening What is the Virchow's triad? - Answer- The three pathological factors associated with thrombus formation: *Can include only 1, 2 or 3 of these factors. •1 Circulatory stasis- reduced blood flow, cause RBCs to clump together •Ex. Long distance travel, varicose veins, pregnancy (venous obstruction), immobility, ventricular/venous insufficiency •2 Vascular damage- blood vessel injury, starts inflammatory process •Ex. Trauma, orthopedic surgery, HTN, invasive lines (cannulation) •3 Hypercoagulability- increase in clotting factors •Ex. Smoking, coagulation disorders, sepsis, malignancy (cancer) Risk factors for DVT: Medical History - Answer- Family or Personal history of blood clotting disorders or blood clots ex: Factor 5 Leiden (inherited gene mutation), DVT, PE Risk Factors for DVT: Surgeries and Procedures - Answer- •Orthopedic procedures (hip, knee, long bone fracture surgeries) within the past month • Invasive lines ex: heart pacemaker is placed through subclavian vein to reach the heart, central line catheter placed in internal jugular vein in neck, PICC line placed though basilic vein in the arm) Risk Factors for DVT: Medications - Answer- •Hormone Replacement Therapy (Estrogen) •Oral contraceptive (birth control pills), especially with smoking Risk Factors for DVT: Cardiovascular Conditions - Answer- Effect blood flow and coagulation •Hypertension (HTN)- (vasoconstriction and damage to vessels decreases blood flow) •Coronary Artery Disease (CAD) ( hardened and damage of vessels decreases blood flow) •Myocardial Infarction (MI) (injury to heart muscle, decreases blood flow) •Peripheral Vascular Disease (PVD)- (condition causes decreased blood flow to lower legs) •Heart Failure (HF) (a weak heart pumping decreases blood flow) •Atrial fibrillation (AF) (irregular beating atria promotes blood coagulation) •Cerebral Vascular Accident (CVA)- decreased blood flow to brain can lead to neuro deficit such as impaired mobility Which client is at the highest risk to develop a deep vein thrombosis? A Client receiving IV fluids through a peripheral line B Client who had a pulmonary embolism last year C Client who is being discharged home after eye surgery D Client who has a family history of hypertension - Answer- B Client who had a pulmonary embolism last year (personal history of DVT is a high risk factor) What are non-modifiable risk factors for DVT? - Answer- family history of Factor V Leiden surgery must be within a month patient must have cancer (family history will not count) Prophylaxis - Answer- Blood clotting prevention that promotes venous return to the heart and decreases coagulation *Often seen in hospital labeled VTE (Venous Thromboembolism) Safety Measures What are the preventative measures of venous thromboembolism (VTE) prophylaxis? - Answer- •Prophylactic anticoagulant therapy ex: SQ Heparin or Lovenox): may lower risk for clots but place client on bleeding precautions, inject 2 inches from navel •Position: elevating foot of bed, knees slightly apart promotes venous blood return but still encourage turning in bed to prevent skin breakdown •Movement: early mobilization, leg exercises after surgery, injury, illness: promotes venous return, but follow fall precautions- nonskid socks •Medical Devices: -TED hoses (thrombo-embolus deterrent) or compression stockings- help increase venous blood return, but should remove at night •SCD (sequential compression device/ intermittent pneumatic compression devices- for clients with limited mobility: promote venous blood return by mimicking muscles contractions when walking, make sure they are turned on and document! What are the key symptoms of DVT? - Answer- Asymptomatic- often there are no symptoms Inflammatory symptoms: -Pain or tenderness to touch *Most common and defining symptom is aching pain in extremity, especially when walking or moving -Erythema- spreading redness -Warmth- some describe as hot -Edema- mild to severe