DEEP VEIN

THROMBOSIS
(DVT)
By Katie Coon and Stephanie Ford
WHAT IS A DVT?
A blood clot in a deep leg
vein caused by abnormal
circulation or clotting of
the blood.
Contributing Factors:
- Being overweight
- Oral contraceptives
- Smoking
- Injury to vein
- Family history - Older age
- Recent surgery - Pregnancy
- Prolonged periods without movement
Complications:
- Shortness of breath or dyspnea
- Chest pain
- Repeated cough/ bloody sputum
- Fever > 100.4 Celsius
- Increased swelling or pain in leg
- Spreading redness
- Unexpected bleeding
HOW SERIOUS IS A DVT?
According to the CDC
approximately 1-2 per 1,000 persons are affected by DVTs each year.
for people over age 80, the incidence increases to 1 per 100 persons.
60,000 100,000 persons dies each year from DVT/PE.





On 4N patients are susceptible to DVTs because
they have had trauma causing vein injury
they have injuries that cause immobility
they are post-operative


IMPLICATIONS OF A DVT
For the patient
Death
Pulmonary embolism
Long term anticoagulants
Increased length in hospital stay

For the institution
Implementation of anticoagulants
Implementation of DVT protocol
Estimated cost is $10,000 per DVT and $20,000 per PE

For healthcare resources
Increase in costs
The need for overall resources increases


PATIENT CARE
Stay off of affected leg as much as possible
When sitting of lying down, keep leg elevated
Use compression stockings to improve blood flow
Move ankles, toes, and knees to stimulate blood flow
Take anticoagulants exactly as directed
PREVENTING A DVT
Improve blood flow back to the heart
Develop a regular exercise program
Lose weight and lower blood pressure
Quit smoking
Elevate legs that feel swollen or heavy
When sitting, wiggle toes and tighten calves
Wear elastic stockings
Monitor vitamin K intake if on anticoagulants
THE NURSING ROLE
Assess
Swelling and pain in one or both legs( pain may only occur when ambulating or
standing)
Warmth of the skin of the affected leg
Red or discolored skin
Fatigue of the leg
Veins are visible at the surface
Positive Homans sign

Plan
Use medications, along with compression devices to diminish the clot
Monitor labs to determine the need for further use of anticoagulants
Diet education (vitamin K)
NURSING ROLE CONT.
Intervene
Elevation of legs
Begin administration of anticoagulants/thrombolytic and analgesics
Monitor labs (PTT, CBC, PT, INR)
Compression devices
Warm compress to affected area
Bed rest

Evaluate
Labs
Pain
Decrease in swelling/edema
D-dimer/ ultrasound
Diet (Vitamin K)
SPECTRUMS INITIATIVES
PREVENTION WITH.
Ambulation
PCDs/SCDs
Anticoagulants
Lovenox
Heparin
Nomogram


EDUCATION MATERIALS
/Library/Encyclopedia/85,P08252

http://www.nursingcenter.com/lnc/journalarticle?Article_ID=11974
98

http://www.cdc.gov/ncbddd/dvt/index.html

http://www.clotconnect.org/healthcare-professionals/patient-
handouts