By: Brittaney Bures

Deep Venous Thrombosis

Objective
For hospitalized patients, are the use of
SCDs effective in DVT prevention?
Pathophysiology
Introduction
A deep venous thrombosis (DVT) is a blood clot that forms
in a vein deep in the body that remains attached to a
vessel wall
- Occur mostly in lower extremities but can also form
in other parts of the body



(Huether & McCance, 2012)

Pathophysiology


Pathophysiology
Risk Factors
Three factors (triad of Virchow) promote venous
thrombosis:
Venous stasis
Venous endothelial damage
Hyper-coagulable states
Overweight or obesity
Smoking



(Huether & McCance, 2012)


Why so important?
Untreated DVTs are associated with a
high risk of blood clots breaking off and
traveling through the blood stream to other
parts of the body (embolization)
Can obstruct blood flow



(Huether & McCance, 2012)
Pathophysiology
Signs and Symptoms
Changes in skin color (redness or discoloration)
Leg pain or tenderness
May only feel when standing or walking
Leg swelling or edema
Skin that feels warm to the touch in the swollen area



(Huether & McCance, 2012)
Pathophysiology
Tests and Diagnosis
Common tests include:
D-dimer blood test
Doppler ultrasound exam of the legs
Venography may be done if ultrasound does not
result in a clear diagnosis.




(Huether & McCance, 2012)
Prevention/Treatment
Prevention
Early ambulation, pneumatic devices, and
prophylactic anticoagulation
Treatment
Anticoagulants** most common medicine
Thrombolytics
Compression stockings
Vena Cava Filter


(Huether & McCance, 2012)




Evidence-Based Article 1
Effectiveness of intermittent pneumatic compression in
reduction of risk of deep vein thrombosis in patients who
have had a stroke: a multicentre randomised controlled
trial
Patients who have had a stroke are at especially high risk; thromboembolism has
been detected in 20-42% of patients in hospital who had a stroke
Conclusion:
IPC is an effective method of reducing the risk of
DVTs and possibly improving survival in a wide
variety of patients who are immobile after stroke.


("Effectiveness of intermittent," 2013)



Evidence-Based Article 2
Complications related to deep venous thrombosis
prophylaxis in trauma: a systematic review of literature

Conclusion:
Mechanical compression devices are not used for
primary thromboprophylaxis, but may be helpful when
pharmacolgic anticoagulants are contraindicated.



(Ball, 2010)
References
Huether, S. E., & McCance, K. (2012). Understanding pathophysiology. (5th
ed.). St. Louis, Missouri: Elsevier Mosby.

Ball, C. G. (2010). Complications related to deep venous thrombosis
prophylaxis in trauma: a systematic review of the literature. Journal of
Trauma Management & Outcomes, Retrieved from
http:///content/4/1/1www.traumamanagement.org

(2013). Effectiveness of intermittent pneumatic compression in reductiono of
risk of deep vein thrombosis in patients who have had a stroke (clots3): a
multicentre randomised controlled trial. The Lancet, 382, Retrieved from
http://www.sciencedirect.com/science/article/pii/S0140673613610508



NCLEX Question
The patient has had abdominal surgery. The nurse is
teaching her about deep vein thrombosis (DVT). The
nurse will include positive conversation and
instruction on all of the following factors except:

A. Exercise can decrease the risk for developing DVT
B. Briskly massage any red, tender areas in the calf
C. Frequent lab work will be necessary
D. Report any leg discomfort immediately
NCLEX Question
A female patient is diagnosed with DVT. Which of
the following nursing diagnosis should receive the
highest priority?

A. Impaired gas exchanged related to increased blood flow
B. Fluid volume excess related to peripheral vascular disease
C. Risk for injury related to edema
D. Altered peripheral tissue perfusion related to venous
congestion
Nursing Diagnosis
Altered peripheral tissue perfusion related to
venous congestion
Questions?