NUR 254 Concept of Perfusion
- Venous thrombosis
Answer Condition in which a thrombus (blood clot) forms on the wall of a vein causing inflammation and some degree of obstruction
- Deep venous thrombosis (DVT)
Answer When thrombus is located in a deep vein of the body, usually in the leg or pelvis.
DVT can break off from site into blood stream, if this moves through the heart to the lungs a Pulmonary Embolism (PE) can occur.
- venous thromboembolism (VTE)
Answer The disease process that includes DVT and/or PE
- DVT Pathophysiology & Etiology
Answer
Deep veins in legs are surrounded by muscles that are powerful enough to push blood back to the heart and lungs.
One way valves prevent backflow of blood back down towards feet.
If blood flow decreases due to illness, injury or inactivity, blood can pool, thus causing a possible
DVT. 1 / 3
- Virchow's triad
Answer hypercoagulability vascular damage
circulatory stasis
- Types of Venous Thrombi
- most common in iliac, popliteal or femoral veins
Answer Superficial venous thrombosis -from IV therapy infusions or venous catheters.Deep Vein Thrombosis (DVT)
- Clot Location
- Popliteal 10%
Answer
- Popliteal and Superficial Femoral
Answer 40 %
- Popliteal, Superficial, and Common Femoral 5%
- All Proximal Veins 35 %
- Common Femoral 8%
- DVT Clinical Manifestions
Answer Usually asymptomatic
Dull, aching pain in affected extremity, especially when walking 2 / 3
Possible tenderness, warmth, erythema Cyanosis, edema of affected extremity
The presence of Homans' sign - calf pain elicited on dorsiflexion of the foot. (not routinely used and is not reliable)
- DVT Diagnostic Tests
Answer Laboratory studies
- D-dimer (global marker of coagulation activation) Duplex venous ultrasonography (aka
- Treatment
Doppler) CT Venography MRI Venography Ascending contrast venography
Answer Mechanical Prophylaxi
Answer sPrevention is KEY!
Mechanical Thromboprophylaxis is used as a prevention of VTE.
- This includes compression stockings, venous foot pumps
- Sequential compression devices (SCD's) (continuous & intermittent)
11. DVT
Answer Surgical Management
Answer Venous Thrombectomy Balloon Angioplasty Stent Placement Inferior vena cava filter (IVC filter)
- Rarely used for DVT, unless massive occlusion or no response with treatment
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