Chronic venous insufficiency and DVT Flashcards
What is an arterial disease
Issue getting blood to the tissues d/t blockage
What is a venous disease
Issues returning blood to the heart d/t backlog
What are some risk factors for chronic venous insufficiency?
- prior DVT
- varicose veins
- prolonged sitting or standing
- obesity
- pregnancy
- inactivity
- smoking
- female
- > 50
what are some elements of data collection for venous insufficiency?
Pain (tightness and heaviness in legs)
Skin changes (heat, skin inspection, redness)
Girth measurements
Test for DVT
Clinical signs and symptoms
stasis dermatitis
lipodermatosclerosis
What is stasis dermatitis
inflammation of the skin due to venous stasis
sx - inflammation, itching, hyperpigmentation
what is lipodermatosclerosis
inflammation of subcutaneous fat in patients
sx- hardening, redness with some white patches and inflammation
What is the disease progression of chronic venous insufficiency
S- spider veins
V - varicose veins
E - edema
P - pigmentation
H - healed ulcer
U - unhealed ulcer
Rehab management for chronic venous insufficiency
BONUS: which of the 3 are contratindicated for mixed arterial diesea
elevation
elastic compression
exercise
ELEVATION AND COMPRESSION
What are the types of compression socks
- Graduated compression socks (general compression)
- anti-embolism stockings (reduce cvt)
- Nonmedical support (hosiery)
Name 5 contraindications if compression stockings
Peripheral arterial disease
allergy to stocking material
local skin or soft tissue conditions
pulmonary edema from CHF
Unusual leg shape preventing proper compression
Give some general education for compression stockings
mention how long to wear them, how to put them on, what to watch out for, hygiene and when its time to replace them
What are potential problems with compression stockings
numbness of discoloration distal to compression, increased pain or severe proximal or distal swelling.
What is the worst case scenario as an outcome for chronic venous insufficiency?
DVT
WHat are 2 contraindications for exercise for chronic venous insufficiency
2 - do they warrant a referral back to the md
Thrombophlebitis and DVT
2 yes
3 DVT is worse that thrombophlebitis and need to be treated with anti-coagulants.
Why is DVT such an important red flag to take care of
it can lead to pulmonary embolism
What are the signs and symptoms of pulmonary embolism
sudden onset of
severe chest pain and SOB
Tachypnea
Tachycardia
Syncope
Shock
What is rehab implications for DVT
used to be bed rest and anticoagulation meds but now early ambulation + anticoagulation is the proper mix.
What are some preventions for DVT
identify high risk patients (elderly and prior DVT Dx)
Avoid prolonged sitting or bed rest
Early mobilization post op
Ankle pumping (secondary hear)
Types of strengthening for post DVT
calf strengthening, walking UH on treamill to improve hemodynamic performance
AEROBIC TRAINING: 13 wekks to heal vs 34 on top of having compression.
