Deep Venous Thrombosis Flashcards
What percentage of patients get a deep venous thrombosis?
10-20%
What is the number one cause of a deep venous thrombosis?
immobility
If the virchow triad occurs what happens?
This is the perfect situation for a DVT
What is the Virchow triad?
(E) -Endothelial damage
(V) -Venous Stasis
(A) -Altered coagulation
In the Virchow triad what does the E in EVA stand for?
Endothelial damage
In the Virchow triad what does the V in EVA stand for?
Venous Stasis
In the Virchow triad what does the A in EVA stand for?
Altered coagulation
In a deep venous thrombosis where does the clot form?
On the wall of the deep vein
A DVT is a common complication of these three things:
Hospitalization
Surgery
Orthopedic procedures
Why are risks increased for DVTs when a patient has an othropedic, abdominal, or thoracic surgery?
The incisions are larger
Why is smoking a risk factor to develop a DVT?
It restricts circulation
If a person exhibits on of the risk factors on the list and takes birth control what is likely to happen?
They are a ticking time bomb for a DVT
Why is a person at risk for a DVT when they have a catheter in their central vein?
Blood cells clump around the catheter and can occlude the line. This clump of cells can end up forming a clot.
Which patient is at highest risk for a venous thromboembolism?
A. A 50-year-old postoperative patient
B. A 25-year-old patient with a central venous catheter in place to treat septicemia
C. A 71-year-old otherwise healthy older adult
D. A pregnant 30-year-old woman due in two weeks
B. A 25-year-old patient with a central venous catheter in place to treat septicemia.
This patient has two risk factors.
As a complication of a DVT venous ulcers can be described as:
A reddened clean edged ulcer right about the ankle. Can be large due to lack of circulation. It typically is shallow with a lack of pain.
Why would venous gangrene be a complication of a DVT?
Blood blood due to a blockage that is created by the DVT
What is varicosities?
A complication of a DVT described as bulging veins.
What are the symptoms of a present DVT?
Calf pain Tenderness Swelling Warmth Erythema (redness)
If a patient has a high D-dimer test what does that mean?
They have a blood clot
What is an ascending contrast venography?
A test where dye is placed into the vein to see if it goes all the way through
As a prophylaxis treatment for a DVT medication is used?
Low molecular weight heparin (enoxoparin)
What is the number a patient wants to be between to maintain their aPTT levels?
1.5-2x control
What is give with warfarin for the first 4-5 days?
IV heparin
What are the doses of warfarin adjusted for?
To maintain an INR of 2.0-3.0
A patient takes warfarin for at least how many months?
3
When should the patient be taken their warfarin?
between 5-6 around dinner time
What is a venous thrombectomy?
When the vein is opened and the clot is removed.
Where is a filter placed if a patient has recurrent thrombosis?
In the Inferior Vena Cava
What happens during a vein ligation?
The affected vein is tied off.
When elevating a patients leg and they have a DVT what should you NOT do?
Elevate the foot of the bed!
Place the foot on a pillow for elevation.
If a patient is on extremity rest due to a DVT how do they use the bathroom?
Bedside commode or bedpan only
When permitted to return to activity what kind of clothing should the patient avoid?
Tight fitting
Where should you not put pressure or pillows in terms of someones leg?
The back of the knee.
When trying to prevent a DVT why would you want to assess IV sites?
If there is any redness you need to change it to prevent clot formation.
What does thrombosis will not embolism mean?
The blood clot won’t move
True or False:
It is not an emergency if a patient with a DVT complains of chest pain.
False:
the thrombosis may have moved.
Why is it important to make where you measured the patients leg as well as document it?
So the next nurse can accurately see if the swelling has increased or decreased.
True or False:
You should put cold packs on a persons calf who has a DVT there.
False:
Only use warm, moist heat
Why is it important to encourage frequent position changes and assess skin frequently.
Skin breakdown can occur rapidly
What does it mean by manage limb care?
Encourage pumping and flexing of feet so venous pooling doesn’t occur.
Why is it important to document that the patient verbalized the warning signs of DVTs?
Most patients are returning to the hospital due to a DVT that was made at home
The nurse teaches the family of an older patient who is at risk for developing a deep venous thrombosis about prevention of the condition. Which of the following will the nurse include in teaching?
- Place pillows under the knees so that hips are flexed.
- Apply elastic hose if swelling develops
- Position client to promote venous return.
- Keep feet squarely on the flood when sitting in a chair.
- Apply elastic hose if swelling develops
