Deep Vein Thrombosis

Risk Factors: Inactivity, bed rest, obesity, C-section, sepsis, smoking, history of DVT, varicose veins, DM, trauma, prolonged labor, > 35 y.o., dehydration, forceps, air travel Signs & Symptoms: Absent in 75% of those affected. Swelling, Erythema, Heat, tenderness, + Homans sign, pain with ambulation, Legpale, cool to touch, Decreased peripheral pulses Etiology: A thrombus is a collection of blood factors; platelets, and fibrin on vessel wall. Thrombi form when blood flow is impeded. 3 main causes: venous stasis, hypercoaguable blood, injury to endothelial surface. http://www.youtube.com/watch? Subjective: My leg is hurting. My leg feels hot. My leg hurts when I walk. Nursing Diagnosis: Knowledge Deficit R/T the process of DVT, lack of information R/T risk of DVT Diagnostic tests: Venous unltrasonography with vein compression and Doppler flow analysis. MRI, DObjective: Swelling, heat, + Homans sign (grimace), malaise, redness Goal: 1) Manage and minimize the complications of DVT 2) Educate patient on signs and symptoms of DVT and to stabilize the patient all within the shift dimmer test (- more accurate than +) Defining Characteristics: Express an interest in learning, Explain knowledge of topicrisk of DVT v=eK5MeJuUQbs

Medications: with continuous IVStart of unfractionated heparin, then move on to SubQ heparin (it prevents enlargement of the clot) 5-25,000 units. levels Continuous for therapeutic Warfarinoverlap with the heparin and then slowly wean off of the heparin. 6 week to 6 eat months. Precautions: Dont foods rich in Vitamin K, Dont take aspirin, Use a soft toothbrush dont shave with a razor use and an electric one d/t risk of herbs bleeding. Caution use of (talk with with the physician), No Douching. Analgesic: Motrin 600-800 mg q every 6 hrs

Interventions: 1) Establish rapport with mother 2) Encourage pelvic rest mother to stay in bed and 3) elevate affected leg 4) Give anticoagulant meds as ordered 5) Take blood as ordered for lab tests 6) Give analgesics as needed 7) Continuous moist heat 8) of Twice a dayor inspect mother for signs bruising petechia 9) Instruct her to report: bruises, in urine or stools, bloody nose, blood bleeding bleeding gums, increased vaginal 10)(tachycardia, Assess for signs of hemorrhage falling BP, other signs of shock) 11) Observe for excessive or bright red lochia 12)symptoms Gradual ambulation after have disappeared 13)regimen Carefully explain treatment 14)contraindicated Educate ptherbs aboutwhen taking Warfarin 15)physician Educate pt to check with before taking OTC drugs. 16)function Assess the family structure and 17) Monitor Labs: aPtt, Pt, INR 18)SCD Use compression stalkings or 19)

Rationales: 1) So mother will feel comfortable 2) To prevent clot from dislodging 3) decrease interstitial swelling and promote venous return 4) so clot will disintegrate 5) to determine response to medication 6) to control pain 7) pain relief and increase circulation 8) may indicate internal bleeding 9) may indicate internal bleeding 10) may indicate internal bleeding 11) therapy may be caused by anticoagulation 12) prevent more clots from forming 13)is being so done pt understand why treatment 14)anticoagulation so py doesnt counteract therapy unknowingly 15)interactions So there are no drug 16)family Determine how prepared the illness is to cope with the mothers 17)therapeutic Make sure levels are within range 18)forming Prevent further clots from if in bed and not moving

Evaluation: 1) The mother no signs demonstrates of unusual or other side bleeding effects of the medication 2) the woman discusses precautions she has taken to prevent hemorrhage 3) Necessary have been made changes in the home.