Cardiovascular 2

Cards (18)

  • 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 (endothelial injury) 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
    • signs and symptoms of pulmonary embolism