Flashcards in Test #5 - Thrombophlebitis & Vericose Veins Deck (24):
What is a Thrombus?
What is Embolus?
What is a Phlebo?
What is Phlebitis?
Inflammation of Veins (Without thrombosis)
What is thrombophlebitis?
Clot and Inflammation of Vein
What is Phlebothrombosis?
Intraluminal clot with minimal or no inflammation
What is DVT, PE, and VTE?
Deep Vein Thrombosis - clot in the non-superficial veins
Pulmonary Emboli - Clot in the lung
Venous Thromboembolism -
What are the signs and symptoms of Pulmonary Emoli?
Sudden onset of chest pain
Dyspnea, increased resp rate, fever, tachycardia, diaphoresis, cough, anxiety
What are some risk factors for DVT?
Surgery, esp orthopedic, trauma & fractures (esp hip and lower extremity), infections, dehydration, abrupt withdrawal of anticoagulants
Inc age, female, smoking, Birth control, IV drug use
Bed rest, immobilization/prolonged sitting or standing
Blood Dyscrasias, Diabetes
Patho - What are some conditions that allow thrombi to form?
Venous Stasis - Veins not moving blood, prolonged bedrest, crossing legs, being paralyzed
Hypercoagulability - Diet, smoking, BC, dehydration, certain meds and any type of hormones
Vessel Injury - Surgery, trauma, extended pressure, hypertension, diabetes, obesity
What is caused when platelets adhere to vessel walls @ BIFURCATIONS DEEP & SUPERFICIAL VEINS, and common sites are ileo-femoral veins, politeal veins, saphenous veins?
What are some S&S of Superficial Thrombophlebitis?
Tenderness/Pain along vein
Induration: Close enough to surface you can touch it if you touch it is hard
*Low risk for PE
What are the S&S of DVT?
UNILATERAL SWELLING (MC)
Low Grade Fever
*S&S are less distinctive; half of patients are asymptomatic
What are some labs and diagnostics for DVT?
Non-Invasive Vascular Tests:
-Doppler (hand held); proximal more than distal
-Venous Ultrasound duplex scanning
Invasive Test: Fluoroscopy with contrast media to visualize abnormalities
-Arteriography - Arterial
-Venography - Venous
What are the goals of DVT treatment?
Prevent extension of thrombus
What are some medical interventions for DVT?
Address Virchow's Triad
1. Promote Venous Return: Leg Exercises, ambulation, SCD's, TED's, post op deep breathing, elevate foot of bed
2. Treat hypercoagulability: Anticoagulants ( Coumadin, heparin), antiplatelets (ASA, plavix), avoid pillows under knees, avoid sitting too long
3.Avoid Vessel Injury: Avoid infiltration of IV's, encourage use of PICCs & ports for tong term IV tx.
What are the normal lab values for PT, PTT, aPTT, Platelet Count and INR?
PTT: 60-70 Sec
aPTT: 30-40 Sec
Platelet Count: 150,000-400,000
What are some information for IVC?
IVenaCava: Filter to get the clots, it is to get the clots and break it down into tiny peices. It doesn't just trap the clot.
What are some risk factors for vericose veins?
Family History of incompetent valves / Cogenital absence of valve or acquired valvular incompetence
Occupation: Prolonged standing/sitting
Obeity, pregnancy, age, gender, femail, tight garments(garter)
What is some pharmacology for vericose veins?
Sclerotherapy: Injection of sclerosing agent into a varicosity. The agent damages the vessel and causes aseptic thrombosis, which results in vein closure.
What are some S&S of vericose veins?
Dull aching pain or discomfort and heaviness that worsens in hot weather
What are some nursing interventions for vericose veins?
TED or support hose
Ensure that feet touch the floor when sitting
Move every hour
Wash skin and pat dry-DO NOT RUB
to avoid tight clothes like girdles and garters
Avoid knee highs that bind at knee
Avoid crossing legs
Avoid chairs that don't fit
What are some surgical interventions for vericose veins?
Laser (Burns to occlude vein)
Vein ligation & stripping (Tying off and removing)