Unit 2_Venous Disorders

Question 1

What do the following influence?

Skeletal Muscle Pump

Respiratory Pump
Inhalation
- Thoracic cavity expands with inhalation, this decreases pressure in pleural cavities
- Pulls blood into the interior vena cava and right atrium
Exhalation
- Thoracic cavity collapses, this increases pleural pressure and pushes blood into the right atrium

One-way valve structure

Answer 1

venous return

Question 2

What venous disorder includes:
Inflammation of a vein.
Possible underlying causes:
- Thrombus/blood clot
- Prolonged inactivity
- Varicose veins
- Trauma

Answer 2

Thrombophlebitis

Question 3

What venous disorder includes:
A blood clot in one of the “deep veins
Common site of formation is in the legs

Answer 3

Deep Venous Thrombosis (DVT)

Question 4

What are the following constitutional signs and symptoms of?
Redness
Swelling
Heat
Pain (decreases with elevation)

Answer 4

Deep Venous Thrombosis (DVT)

Question 5

What are the following causes of?
Right-side Chronic Heart Failure
Chronic Liver Disease
Venous grafts (example - Saphenous Graft with CABG)

Can develop Venous Stasis Ulcers
Most occur on the medial lower leg (near medial malleolus)

Answer 5

Venous Insufficiency with Venous Stasis

Question 6

What DVT consequence occurs when embolus blocks vasculature in the lungs?

Signs and Symptoms:
Coughing
Dizziness
Heart palpitations
Leg pain or swelling
Sharp and sudden chest pain
Shortness of breath that worsens with exertion

Can lead to death (10% are fatal)
Sudden cardiac death
Pulmonary hypertension
Lung infarct

Answer 6

Pulmonary Embolism

Question 7

What DVT consequence occurs when embolus moves thorough a ventricular septal defect?

Answer 7

Paradoxical embolus – Stroke

Question 8

What blocks the left and right pulmonary arteries?

Answer 8

Saddle Embolus

Question 9

What do the follow support diagnosis of?
D-dimer test: Blood test that detects fibrin levels

Echocardiogram
CT scan
Doppler ultrasound

Well’s Criteria (2 or more points = high risk for DVT) Source: Physiopedia

Answer 9

DVT Diagnosis

Question 10

What do the following treat:
Anticoagulation treatment
Inferior vena cava filer

Followed by mobilization and lifestyle modifications
Avoid smoking
Avoid oral contraceptives
Avoid prolonged immobility
Promote hydration
Maintain a healthy weight
Compression stockings during periods of forced immobility (“hospital”)
Intermittent pneumatic compression

Answer 10

DVT Treatment

Question 11

What do the following rehabilitation decisions support?
Make prudent decisions regarding safe mobility in conjunction with the health care team.

Advocate for diagnostic testing and wait the results before mobilizing patients with suspected DVT.

Screen for fall-risk when a patient is on anticoagulation therapy.

Engage patients with known DVT in early mobilization. Recommendations depends on medical treatment:
Anticoagulation
1. Verify initiation of anticoagulation and type.
2. Determine if therapeutic levels of anticoagulation have been achieved.
3. Mobilize the patient once he/she is in a therapeutic range.*

IVC Filter
1. Verify placement of an IVC filter.
2. Mobilize the patient once he/she is hemodynamically stable.

Out of bed ordered for a patient with no anticoagulation therapy or IVC filter
1. Consult with the medical team regarding mobility vs continued bed rest.

Answer 11

DVT