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Clotting
| Question | Answer |
|---|---|
| Thrombus | A blood clot believed to result from an endothelial injury, venous stasis, or hypercoagulability |
| Thrombophlebitis | A thrombus that is associated with inflammation and most commonly occurs in the deep veins of the lower extremities |
| Deep Vein Thrombosis (DVT) | Most common type of thrombophlebitis and may present a greater risk for PE |
| Pulmonary embolism (PE) | Medical emergency that occurs when a dislodged blood clot travels to the pulmonary artery |
| Virchow triad | Stasis of blood flow, endothelial injury, and/or hypercoagulability |
| S/S of DVT | -Calf or groin tenderness and pain -Sudden onset of unilateral swelling of leg |
| Homans Sign | Pain in the calf on dorsiflexion of the foot |
| Risk Factors for VTE | -Sitting/bedrest for long periods of time -Recent surgical procedures -Any factors that may affect coagulation |
| VTE Risk Assessment | This should be done on all patients on admission and whenever the clinical situation changes |
| The Joint Commission | This organization provides accreditation for health care institutions. They collect data on areas such as VTE prophylaxis and management. |
| Venous Duplex Ultrasonography | A noninvasive ultrasound that assesses the flow of blood through the veins of the arms and legs. |
| D-Dimer | A global marker of coagulation activation and measures fibrin degradation products produced from fibrinolysis. < 0.5 mcg/mL (< 0.5 mg/L) |
| MRI | A noninvasive test that is more useful in finding a DVT in the proximal deep veins and better than traditional venography in finding DVT in the inferior vena cava or pelvic veins. |
| VTE-1 | The core measure assesses the number of patients who received VTE prophylaxis OR have documentation regarding why no VTE prophylaxis was given. |
| Anticoagulants | A class of drugs that are the choice for actual DVTs and for patients at risk for DVTs, but are also known to cause medical complications and even death. |
| S/S of Bleeding | -Hematuria -Frank or occult blood in stool -Ecchymosis -Petechia -Altered level of consciousness -Pain |
| Enoxaparin or Lovenox | Low-molecular-weight heparin that is administered subQ. it has a consistent action and is preferred for prevention and treatment of DVT. |
| Warfarin (Coumadin) | Oral anticoagulant that may be added to UFH to provide drug overlap. It inhibits Vitamin K clotting factors and takes 3-4 days to reach therapeutic levels. |
| Interventions for moderate-to-high risk prevent VTE | -Patient education -Leg exercises -Early ambulation -Adequate hydration -Compression stockings -SCDs -Anticoagulant therapy |
| Unfractionated Heparin Therapy (UFH) | Conventional IV treatment for DVT is often prescribed to prevent further clotting. Prior to administration, a baseline prothrombin time (PTT) and aPTT, and INR are required. |
| Inferior Vena Cava Filter | A device that is designed to trap emboli in the inferior vena cava before they progress to the lungs. For clients with recurrent DVT or PE that do not respond to medical treatment and anticoagulation therapy. |
| Vitamin K | Clients taking warfarin therapy should eat only small amounts of foods that are rich with this vitamin. ex. Dark leafy greens |
| Thrombectomy | Surgical procedure for clot removal |
Created by:
NikkiLeigh83
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