Phlebitis is the inflammation of a superficial vein
Venous thrombosis involves the formation of a thrombus and inflammation of the vein. It can be deep or superficial
Venous thromboembolism: spectrum from deep vein thrombosis to pulmonary embolus
Superficial vein thrombosis is the formation of a thrombus in a superficial vein VS deep vein thrombosis is a thrombus in a deep vein
Virchow’s triad is a triad of factors that predisposes one to venous thrombosis. They include stasis of blood flood, local trauma to the vessel wall (endothelialinjury) and hypercoagulability
Venous stasis can be caused by bedrest, orthopedic surgery, paralysis, varicose vein, etc. The blood is stagnant and does not circulate
Endothelial damage can be caused by a direct injury (IV catheter) or an indirect injury (chemotherapy, diabetes). It consists of damage to the lining of the blood vessel
Hypercoagulability can be caused by malignancy, cigarette smoking, estrogen based oral contraceptives
Clinical manifestations of superficial thrombosis
palpable, firm, subcutaneous cordlike vein with tender, red and warm surrounding area
mild systemic temperature elevation and leukocytosis (increased WBC)
extremity edema possibility
Clinical manifestations of DVT:
possible unilateral leg edema
extremity pain and tenderness with palpation
dilated superficial vein
sense of fullness in thigh or calf
paresthesia (numbness or tingling)
warm skin and erythema
elevated systemic temperature
The most serious complication of DVT is a pulmonary embolism (clot in capillaries of lungs)
Deep vein thrombosis is a clot stuck to the blood vessel VS embolism is a clot that travels through the bloodstream
Assessment for venous thromboembolism
past health history
medications
clinical manifestations
physical examination
Diagnostic studies for DVT
ultrasounds
D-dimer: increased values with venous thrombosis and pulmonary embolism (blood test)
Prevention of DVT
early ambulation
change positions
leg exercises
compression stockings or sequential compression devices
prophylactic anticoagulants (prevent clot)
The calf muscle acts as a pump for deep leg veins. Compression stocking can imitate the muscle contraction
When DVT exists, anticoagulants prevent the extension of the clot as well as the development of new thrombi and embolization. Some patients require surgical therapy like a vena cava filter, which filters out clots as blood returns to the right side of the heart
WTE health teaching
address risk factors
use graduated compression stockings
information on anticoagulant administration, dosage and adverse effects