Chronic venous insufficiency and DVT

Question 1

What is an arterial disease

Answer 1

Issue getting blood to the tissues d/t blockage

Question 2

What is a venous disease

Answer 2

Issues returning blood to the heart d/t backlog

Question 3

What are some risk factors for chronic venous insufficiency?

Answer 3

• prior DVT
• varicose veins
• prolonged sitting or standing
• obesity
• pregnancy
• inactivity
• smoking
• female
• > 50

Question 4

what are some elements of data collection for venous insufficiency?

Answer 4

Pain (tightness and heaviness in legs)
Skin changes (heat, skin inspection, redness)
Girth measurements
Test for DVT

Question 5

Clinical signs and symptoms

Answer 5

stasis dermatitis
lipodermatosclerosis

Question 6

What is stasis dermatitis

Answer 6

inflammation of the skin due to venous stasis
sx - inflammation, itching, hyperpigmentation

Question 7

what is lipodermatosclerosis

Answer 7

inflammation of subcutaneous fat in patients
sx- hardening, redness with some white patches and inflammation

Question 8

What is the disease progression of chronic venous insufficiency

Answer 8

S- spider veins
V - varicose veins
E - edema
P - pigmentation
H - healed ulcer
U - unhealed ulcer

Question 9

Rehab management for chronic venous insufficiency

BONUS: which of the 3 are contratindicated for mixed arterial diesea

Answer 9

elevation
elastic compression
exercise

ELEVATION AND COMPRESSION

Question 10

What are the types of compression socks

Answer 10

1. Graduated compression socks (general compression)
2. anti-embolism stockings (reduce cvt)
3. Nonmedical support (hosiery)

Question 11

Name 5 contraindications if compression stockings

Answer 11

Peripheral arterial disease
allergy to stocking material
local skin or soft tissue conditions
pulmonary edema from CHF
Unusual leg shape preventing proper compression

Question 12

Give some general education for compression stockings

Answer 12

mention how long to wear them, how to put them on, what to watch out for, hygiene and when its time to replace them

Question 13

What are potential problems with compression stockings

Answer 13

numbness of discoloration distal to compression, increased pain or severe proximal or distal swelling.

Question 14

What is the worst case scenario as an outcome for chronic venous insufficiency?

Answer 14

DVT

Question 15

WHat are 2 contraindications for exercise for chronic venous insufficiency
2 - do they warrant a referral back to the md

Answer 15

Thrombophlebitis and DVT
2 yes
3 DVT is worse that thrombophlebitis and need to be treated with anti-coagulants.

Question 16

Why is DVT such an important red flag to take care of

Answer 16

it can lead to pulmonary embolism

Question 17

What are the signs and symptoms of pulmonary embolism

Answer 17

sudden onset of
severe chest pain and SOB
Tachypnea
Tachycardia
Syncope
Shock

Question 18

What is rehab implications for DVT

Answer 18

used to be bed rest and anticoagulation meds but now early ambulation + anticoagulation is the proper mix.

Question 19

What are some preventions for DVT

Answer 19

identify high risk patients (elderly and prior DVT Dx)
Avoid prolonged sitting or bed rest
Early mobilization post op
Ankle pumping (secondary hear)

Question 20

Types of strengthening for post DVT

Answer 20

calf strengthening, walking UH on treamill to improve hemodynamic performance
AEROBIC TRAINING: 13 wekks to heal vs 34 on top of having compression.