how will the nurse know that treatment of deep vein thrombosis was sucessful

by Orland Langworth III Published 3 years ago Updated 2 years ago

What is the nursing care plan for deep vein thrombosis?

Nursing Care Plans. The nursing care plan for the client with deep vein thrombosis include: providing information regarding disease condition, treatment, and prevention; assessing and monitoring anticoagulant therapy; providing comfort measures; positioning the body and encouraging exercise ; maintaining adequate tissue perfusion;

What is DVT on the NCLEX for nursing students?

Deep Vein Thrombosis ( DVT) NCLEX review for nursing students! A deep vein thrombosis is a type of venous thromboembolism (VTE). It is important that you’re familiar with the signs and symptoms, preventive measures, treatment, and pathophysiology for a DVT.

What are the five (5) nursing care plans for DVT?

Here are five (5) nursing care plans for Deep Vein Thrombosis (DVT): Impaired Gas Exchange. Ineffective Peripheral Tissue Perfusion. Acute Pain. Deficient Knowledge. Risk For Bleeding.

What is the objective of treatment of deep venous thrombosis (DVT)?

The objective of treatment of DVT involves preventing the clot from dislodgement (risking pulmonary embolism) and reducing the risk of post-thrombotic syndrome.

How does a nurse assess for a deep vein thrombosis?

The D-dimer test is sometimes done in primary care by the assessing nurse but can also be done in hospital. Patients with a likely two-level Wells DVT score (two points or above) should have a proximal leg vein ultrasound scan (USS) within four hours. If the result is negative, a D-dimer test should be performed.

What interventions would a nurse use for a patient with a DVT?

The major nursing interventions that the nurse should observe are: Provide comfort. Elevation of the affected extremity, graduated compression stockings, warm application, and ambulation are adjuncts to the therapy that can remove or reduce discomfort.

How do you evaluate deep vein thrombosis?

Duplex ultrasonography is an imaging test that uses sound waves to look at the flow of blood in the veins. It can detect blockages or blood clots in the deep veins. It is the standard imaging test to diagnose DVT. A D-dimer blood test measures a substance in the blood that is released when a clot breaks up.

What is the best laboratory evaluation for deep vein thrombosis?

Routine blood tests that have the potential to help clinicians stratify patients with the risk for deep venous thrombosis (DVT) include D-dimer assay; levels of antithrombin III (ATIII), N-terminal pro-brain natriuretic peptide (NT-proBNP), and C-reactive protein (CRP); and erythrocyte sedimentation rate (ESR).

What is treatment for deep vein thrombosis?

Blood Thinners. These drugs, also called anticoagulants, are the most common treatment for DVT. They can keep a clot from growing or breaking off, and they prevent new clots from forming.

Which nursing goal would be appropriate for the client with deep vein thrombosis?

The nursing care plan for the client with deep vein thrombosis include: providing information regarding disease condition, treatment, and prevention; assessing and monitoring anticoagulant therapy; providing comfort measures; positioning the body and encouraging exercise; maintaining adequate tissue perfusion; and ...

What is the first step in managing deep vein thrombosis?

The standard initial management of deep vein thrombosis has traditionally meant admission to hospital for continuous treatment with intravenous unfractionated heparin. Treatment then continued with a transition to long term use of oral anticoagulants (vitamin K antagonists).

Which diagnostic study is used to detect deep vein thrombosis in the clients lower extremities?

Tests to diagnose a DVT Magnetic Resonance Imaging (MRI) or Magnetic Resonance Venography (MRV).

What are the complications of deep vein thrombosis?

Complications from deep vein thrombosis can be very serious. They can include pulmonary embolism (PE), chronic venous insufficiency, and post-thrombotic syndrome....Symptoms may include:Chest pain.Trouble breathing or sudden shortness of breath.Coughing (may cough up blood)Fainting.Fast heartbeat.Sweating.

What lab values are affected by DVT?

Protein S, protein C, ATIII, factor V Leiden, prothrombin 20210A mutation, antiphospholipid antibodies, and homocysteine levels can be measured. Deficiencies of these factors or the presence of these abnormalities all produce a hypercoagulable state. These are rare causes of DVT.

When do you monitor PT?

Most often, the prothrombin time is monitored if you are taking the blood-thinning medication warfarin. In this situation, the prothrombin time is expressed as an international normalized ratio (INR).

What is Deep Vein Thrombosis?

Deep vein thrombosis is a part of a condition called venous thromboembolism.

Why is deep vein thrombosis considered a serious condition?

Deep vein thrombosis is a serious condition because blood clots in the veins can break loose, travel through the bloodstream, and obstruct the lungs, blocking blood flow.

What is a thrombus in veins?

Formation of a thrombus frequently accompanies phlebitis, which is an inflammation of the vein walls. Platelet aggregates. Venous thrombi are aggregates of platelets attached to the vein wall that have a tail-like appendage containing fibrin, white blood cells, and many red blood cells. Tail.

What is tail in thrombus?

Tail. The “tail” can grow or can propagate in the direction of the blood flow as successive layers of the thrombus form. Fragmentation. Fragmentation of the thrombus can occur spontaneously as it dissolves naturally, or it can occur with an elevated venous pressure. Recanalization.

Why is my extremity swollen and tense?

Edema. With obstruction of the deep veins comes edema and swelling of the extremity because the outflow of venous blood is inhibited. Phlegmasia cerulea dolens. Also called massive iliofemoral venous thrombosis, the entire extremity becomes massively swollen, tense, painful , and cool to the touch. Tenderness.

Why do you need a blood test?

Blood tests. The patient should be aware that periodic blood tests are necessary to determine if a change in medication or dosage is required .

What is compression therapy?

Compression therapy. Graduated compression stockings reduce the caliber of the superficial veins in the leg and increase flow in the deep veins; external compression devices and wraps are short stretch elastic wraps that are applied from the toes to the knees in a 50% spiral overlap; intermittent pneumatic compression devices increase blood velocity beyond that produced by the stockings.

What is the goal of deep vein thrombosis?

The main goal of treatment of deep vein thrombosis is to relieve acute symptoms, prevent the propagation of blood clots, restore venous patency, prevent the formation of further pulmonary embolism and maintain venous valvular function.

What is a DVT?

DVT (Deep vein thrombosis) in the leg involves clot formation in the lower extremities. Mostly superficial femoral veins, peroneal veins, popliteal and posterior tibial veins are affected in the leg.

What causes a clot in the leg?

DVT (Deep vein thrombosis) in the leg involves clot formation in the lower extremities. Mostly superficial femoral veins, peroneal veins, popliteal and posterior tibial veins are affected in the leg. Due to various causative factors of deep vein thrombosis, venous stasis occurs, blood flow is reduced and there is also a reduction in skeletal muscle contraction. Damage occurs to the blood vessel wall and it provides a suitable site for clot formation. Thrombus formation promotes phlebitis. The thrombus contains fibrin, white blood cells, and red blood cells, it forms a tail-like structure and gradually grows. It blocks the blood flow and hampers venous return.

What causes venous thrombosis?

The exact cause of venous thrombosis is unclear. Mainly three factors of Virchow’s triad like venous stasis, vessel wall injury, and altered blood coagulation. Thrombophlebitis occurs with thrombus formation. Due to the stasis of blood thrombus formation occurs. If thrombus formation occurs without any inflammation, it is called phlebothrombosis. It can occur in any veins but it mostly occurs in superficial and deep veins of extremities.

What is the name of the condition where blood clots form in the legs?

Deep vein thrombosis is also known as venous thromboembolism. Various venous disorders reduce the blood flow and lead to thrombus (clot) formation inside the vein. It mostly occurs in the legs. It interrupts blood flow.

What is the best treatment for pulmonary embolism?

Anticoagulants are commonly used to treat DVT and pulmonary embolism. These medications reduce the clotting capacity of the blood, prevent clot formation, and gradually reabsorbs the clot.

What position promotes rapid venous return?

Periodically lift the lower extremity, if the patient is sleeping on the bed. This position promotes rapid venous return.

What is a deep vein thrombosis nursing plan?

A deep vein thrombosis nursing care plan includes assessment of the body parts, appropriate intervention, prevention, and patient education to prevent thromboembolism.

Why is thrombolytic therapy used in severe cases?

Thrombolytic therapy is started in severe cases. Clot lysis increases the risk of bleeding more than anticoagulation because of its ability to dissolve undesired and therapeutic clots. Therefore its use is restricted to only severe cases of thromboembolism that significantly compromise the blood flow. This therapy must be started within 5 days of onset of symptoms.

What are the factors that contribute to DVT?

Assess the factors that promote DVT like immobility, leg trauma, intraoperative positioning (in older patients), dehydration, varicose veins, smoking, venous stasis, obesity, malignancy, pregnancy, and use of oral contraceptives.

What does it mean to measure oedema?

Measurement is to document and analyze the progression of oedema or swelling in the legs. Unequal leg circumference indicates DVT in some patients.

Where are venous ulcers located?

Venous stasis ulcers are mainly located around the medial malleolus or pretibial and lateral tibial areas of the ankle

Why do you need anticoagulants?

Anticoagulants are given to prevent further clot formation. The type of medication depends on the severity of the clot.

What is the purpose of thrombocystectomy?

Thrombectomy is done to excise the clot if a major vein is occluded.

How to treat DVT?

DVT is most commonly treated with anticoagulants, also called blood thinners. These drugs don't break up existing blood clots, but they can prevent clots from getting bigger and reduce your risk of developing more clots. Blood thinners may be taken by mouth or given by IV or an injection under the skin.

How to diagnose DVT?

Diagnosis. To diagnose DVT, your doctor will ask you about your symptoms. You'll also have a physical exam so that your doctor can check for areas of swelling, tenderness or changes in skin color. The tests you have depend on whether your doctor thinks you are at a low or a high risk of DVT. Tests used to diagnose or rule out a blood clot include: ...

What blood thinners are used for DVT?

The most commonly used injectable blood thinners for DVT are enoxaparin (Lovenox) and fondaparinux (Arixtra). After taking an injectable blood thinner for a few days, your doctor may switch you to a pill. Examples of blood thinners that you swallow include warfarin (Jantoven) and dabigatran (Pradaxa).

What is a clot buster?

Clot busters. Also called thrombolytics, these drugs might be prescribed if you have a more serious type of DVT or PE, or if other medications aren't working.

What blood test is used to diagnose a blood clot?

Tests used to diagnose or rule out a blood clot include: D-dimer blood test. D dimer is a type of protein produced by blood clots. Almost all people with severe DVT have increased blood levels of D dimer. A normal result on a D-dimer test often can help rule out PE. Duplex ultrasound.

How many goals are there for DVT?

There are three main goals to DVT treatment.

What to do if you can't take medicine to thin your blood?

If you can't take medicines to thin your blood, you might have a filter inserted into a large vein — the vena cava — in your abdomen. A vena cava filter prevents clots that break loose from lodging in your lungs. Compression stockings. These special knee socks reduce the chances that your blood will pool and clot.

What is the nursing care plan for a client with deep vein thrombosis?

What is the objective of DVT treatment?

The objective of treatment of DVT involves preventing the clot from dislodgement (risking pulmonary embolism) and reducing the risk of post-thrombotic syndrome.

What is the cause of venous stasis?

Venous stasis occurs when blood flow is decreased, as in immobility, medication therapies and in heart failure. Hypercoagulability occurs most commonly in clients with deficient fluid volume, pregnancy, oral contraceptive use, smoking, and some blood dyscrasias. Venous wall damage may occur secondary to venipuncture, certain medications, trauma, and surgery. The objective of treatment of DVT involves preventing the clot from dislodgement (risking pulmonary embolism) and reducing the risk of post-thrombotic syndrome.

What are the contributing factors to deep vein thrombosis?

Three contributing factors (known as Virchow’s triad) can lead to the development of deep vein thrombosis (DVT) which includes venous stasis, hypercoagulability, and a vessel wall injury. Venous stasis occurs when blood flow is decreased, as in immobility, medication therapies and in heart failure. Hypercoagulability occurs most commonly in clients ...

What is the name of the thrombolytic agent?

Thrombolytic agents, such as alteplase (Activase, tPA), anistreplase (APSAC, Eminase), reteplase (Retavase), streptokinase (Kabikinase, Streptase), tenecteplase (TNKase) and urokinase (Abbokinase) These agents intended to bring about clot lysis (breakdown of the clot) and immediate normalization of venous blood flow.

Where does venous thrombophlebitis occur?

Typically, venous thrombophlebitis occurs in the lower extremities. It may also occur in superficial veins such as cephalic, basilic, and greater saphenous veins, which usually is not life threatening and does not necessitate hospitalization, or it may happen in a deep vein, which can be life-threatening because clots may travel to the bloodstream and cause a pulmonary embolism.

What is the purpose of a therapist's brief explanation of what is happening and expected effects of an intervention?

Provide brief explanations of what is happening and expected effects of an intervention. Relieves anxiety related to unknown and may help decrease fears regarding personal safety. Encourage expression of feelings and inform the client and significant others of normalcy of anxious feelings and sense of impending doom.

What is a deep vein thrombosis?

A deep vein thrombosis is a type of venous thromboembolism (VTE). It is important that you’re familiar with the signs and symptoms, preventive measures, treatment, and pathophysiology for a DVT.

What is heparin induced thrombocytopenia?

Heparin Induced Thrombocytopenia (HIT) Postpartum Period. E ndothelial damage to the vein: This endothelial is a layer of cells that lines the inside of the vein. Damage to this layer can be from a direct or indirect cause, but regardless it stimulates platelets and the coagulation process.

What is a clot in a vein?

What is it? It’s the formation of a clot within a deep vein. It’s a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein. The other type of VTE is a pulmonary embolism, which is where a deep vein thrombosis breaks off within the vein and goes to the lungs. A pulmonary embolism is a risk from the development of a DVT.

Why is fibrin a problem?

Fibrin causes the big problem in terms of a clot developing because fibrin is like strands of mesh. This causes WBCs, RBCs, and platelets to stick together within the vein. This forms a clot and it continues to grow, which can eventually break off and enter venous circulation.

What is compression stocking?

Compression stockings per MD order: provides a specific amount of compression to help decrease risk of blood clot development.

What is thrombolytics with tPA?

Thrombolytics: catheter-directed thrombolysis with t PA…clot busting agent delivered directly to the clot (watch out for bleeding).

How does blood flow back to the heart?

Therefore, the blood has to flow back to the heart via the veins, and it does this with the assistance of healthy vein valves and the muscles within the extremity. If the vein’s valves are damaged or the muscles aren’t working (or being used) blood isn’t going to flow back very well and a blood clot can develop.

What is objective data in DVT?

So the objective data, or the things that the nurse observes, data collected by labs, things like that. So, for this patient with our DVT, you’re going to have the unilateral findings of the affected extremity. We might assess some warmth, redness right to that extremity as that blood flow is getting backed up, swelling, ,decreased peripheral pulses on that one side, and then how about a positive D-dimer on the lab showing us that there is a high likelihood that there’s a blood clot.

What is the purpose of stabilizing blood clots?

Stabilization of the blood clot or disintegration of the blood clot as well as prophylaxis treatment for future blood clots. Prevention of complications such as embolic strokes, myocardial infarction, or pulmonary embolism.

Why do we need to do prophylaxis for anticoagulants?

And then why? So, prophylaxis for the anti-coagulants, we’re preventing further clots from forming, we’re preventing the growth of this one clot that we have, and then surgery, just to remove that clot, catch it, or keep it from moving through the bloodstream and causing bigger problems.

What organs can be affected by thrombophlebitis?

A potential complication of thrombophlebitis and DVT is thrombi can break off and become emboli to other vital organs such as the lungs (PE), heart (MI), or brain (CVA). Monitor for signs of these occurrences. Administer Heparin-Transition into a SubQ or oral anticoagulant to prevent future clots.

What is expected outcome of patient education?

In our expected outcomes, with patient education, we expect that the patient will verbalize or demonstrate an understanding of this education.

What are the causes of thrombophlebitis?

Other major causes are prolonged sitting, pregnancy, smoking, and birth control. Virchow’s triad explains the 3 major contributors to the development of thrombophlebitis: venous stasis, damage to the inner lining of the vessel, and hypercoagulability.

How long should you wait to go to the ER for a nosebleed?

Epistaxis: Nosebleeds are obvious, however, inform the patient that if they bleed through nasal packing for longer than 15 minutes they should go to the ER. Also, they feel dizzy, faint, or are losing color in their face they should go to the ER.

Why is DVT important?

An accurate diagnosis of DVT is extremely important to prevent potentially fatal acute complication of pulmonary embolism (PE) and long-term complications of postphlebitis syndrome and pulmonary hypertension. It is also important to avoid unjustified therapy with anticoagulants with associated high risk of bleeding in patients misdiagnosed with the condition.1

What is DVT in a vein?

Deep vein thrombosis (DVT) is the formation of blood clots (thrombi) in the deep veins . It commonly affects the deep leg veins (such as the calf veins, femoral vein, or popliteal vein) or the deep veins of the pelvis. It is a potentially dangerous condition that can lead to preventable morbidity and mortality.

What is a VTE?

Uncommon presentations of VTE are forms of acute massive venous thrombosis with obstruction of venous drainage to the extremity. These include phlegmasia alba dolens, phlegmasia cerulea dolens, and venous gangrene. In phlegmasia alba dolens, the thrombosis involves only the major deep venous channels of the extremity, sparing collateral veins. However, in phlegmasia cerulea dolens, the thrombosis extends to the collateral vein, resulting in massive fluid sequestration and more significant edema.

What is the risk of DVT in long-haul flights?

Oral contraceptive pills, especially those that contain third-generation progestins increase the risk of VTE.28Risk of DVT associated with long-duration air travel is called economy class syndrome.29It is 3% to 12% in a long-haul flight with stasis, hypoxia, and dehydration being pathophysiological changes that increase the risk.30van Aken et al demonstrated that subjects with elevated levels of interleukin-8 have increased risk of venous thrombosis, supporting an important role of inflammation in etiopathogenesis of venous thrombosis.31

What is the best test for DVT?

Venography is the definitive diagnostic test for DVT, but it is rarely done because the noninvasive tests (D-dimer and venous ultrasound) are more appropriate and accurate to perform in acute DVT episodes. It involves cannulation of a pedal vein with injection of a contrast medium, usually noniodinated, eg, Omnipaque.

How low is the incidence of VTE?

The incidence of VTE is low in children. Annual incidences of 0.07 to 0.14 per 10,000 children and 5.3 per 10,000 hospital admissions have been reported in Caucasian studies.6,7This low incidence may be due to decreased capacity to generate thrombin, increased capacity of alpha-2-macroglobulin to inhibit thrombin, and enhanced antithrombin potential of vessel walls. The highest incidence in childhood is during the neonatal period, followed by another peak in adolescence.8The incidence rate is comparatively higher in adolescent females because of pregnancy and use of oral contraceptive agents.9

What is the term for the formation of an abnormal mass within the vascular system of a living animal?

The term thrombosis refers to the formation, from constituents of blood, of an abnormal mass within the vascular system of a living animal. When this process occurs within the deep veins, it is referred to as deep vein thrombosis (DVT).

What Is Deep Vein Thrombosis?

Pathophysiology

Statistics and Incidences

Causes

Clinical Manifestations

Prevention

Deep vein thrombosis can be prevented, especially if patients who are considered high risk are identified and preventive measures are instituted without delay. 1. Graduated compression stockings.Compression stockings prevent dislodgement of the thrombus. 2. Pneumatic compression device.Intermittent pneumatic compression devices increase blood veloc...