What is thrombolphlebitis?

 Thrombophlebitis is an inflammatory process that cause a blood clot to form

and block one or more veins, usually in your legs
 The area is usually reddened, tender, and warm to touch and can be painful
 The affected veins might be near the surface of your skin(superficial
thromboplebitis) or deep within a muscle(deep vein thrombosis or DVT)
Signs and symptoms during pregnancy
Pain is the common symptom, when there is a severe pain in one limb you should
report to the doctor immediately. The danger is that the clot could dislodge and cause
problems in your body.
Other symptoms include:

 Warm skin to the are infected

 Tenderness
 Slight to severe swelling

Causes

 Injury to a vein
 Inherited blood-clotting disorder
 Being immobile for long periods, such as during injury or a hospital stay

Risk factors

 Inactivity, either because you’re confined to bed or you're travelling in a car or

plane for a long period of time
 Have varicose veins, which are common cause of superficial thromboplebitis
 Are pregnant or have just given birth
 Have a family history of blood-clotting disorder or a tendency to form blood
clots
 Have had previous episodes of thrombophebitis
 Had a stroke
 Smoker
Treatment

 Blood-thinning medications. If you have deep vein thrombosis, injection of a

blood-thinning (anticoagulant) medication, such as low molecular weight
heparin, fondaparinux (Arixtra) or apixaban (Eliquis), will prevent clots from
growing bigger. After the first treatment, you'll likely be told to take warfarin
(Coumadin, Jantoven) or rivaroxaban (Xarelto) for several months to keep
preventing clot growth. Blood thinners can cause excessive bleeding. Always
follow your doctor's instructions carefully.
  Clot-dissolving medications. Treatment with a clot-dissolving drug is called
thrombolysis. The medication alteplase (Activase) is used to dissolve blood
clots in people with extensive DVT, including those who have a blood clot in
the lungs (pulmonary embolism).
 Compression stockings. Prescription-strength compression stockings help
prevent swelling and reduce the chances of complications of DVT.
 Vena cava filter. If you can't take blood thinners, a filter may be inserted into
the main vein in your abdomen (vena cava) to prevent clots that break loose in
leg veins from lodging in your lungs. Usually, the filter is removed when it's
no longer needed.
 Varicose vein stripping. Your doctor can surgically remove varicose veins that
cause pain or recurrent thrombophlebitis. The procedure involves removing a
long vein through small incisions. Removing the vein won't affect blood flow
in your leg because veins deeper in the leg take care of the increased volumes
of blood.
Diagnostic test

 Duplex ultrasonography is an imaging test that uses sound waves to look at the
flow of blood in the veins. It can detect blockages or blood clots in the deep
veins.  It is the standard imaging test to diagnose DVT.
 A D-dimer blood test measures a substance in the blood that is released when
a clot breaks up. If the D-dimer test is negative, it means that the patient
probably does not have a blood clot.
 Contrast venography is a special type of X-ray where contrast material (dye) is
injected into a large vein in the foot or ankle so that the doctor can see the
deep veins in the leg and hip.  It is the most accurate test for diagnosing blood
clots, but it is an invasive procedure, which means it is a medical test that
requires doctors to use instruments to enter the body. Therefore, this test has
been largely replaced by duplex ultrasonography, and it is used only in certain
patients.
 Magnetic resonance imaging (MRI)—a test that uses radio waves and a
magnetic field to provide images of the body—and computed tomography
(CT) scan—a special x-ray test—are imaging tests that help doctors diagnose
and treat a variety of medical conditions.  These tests can provide images of
veins and clots, but they are not generally used to diagnose DVT.
Nursing care

 Monitor capillary refill time; Assess for positive Homans’ sign (calf pain at
dorsiflexion of the foot)
 Assess respiration and auscultate for lung sounds, noting crackles or friction
rub. Investigate reports of chest pain or feelings of anxiety.
 Maintain bed rest with elevation of feet and lower legs in above heart level
during the acute phase.
 Elevate client’s legs when resting or sitting in a chair.
 Instruct client to avoid crossing the legs or wear constrictive clothing.