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JM Thrombophlebitis
Thrombophlebitis
| Question | Answer |
|---|---|
| What is thrombophlebitis? | Inflammation of the venous walls with the formation of a clot;also know as venous thrombosis, phlebothrombosis, DVT. |
| What nursing assessment may be observed with thrombophlebitis? | Calf pain if calf is involved, positive Homan sign (only about 10% pt manifest this sign&a lot of false positives); |
| What may be seen in the extremities with AAA? | Functional impairment of extremity, edema and warmth in extremity,asymmetry (inspect legs from groin to feet, measure diameters of calves;tender areas on affected extremity with very gentle palpation. |
| What diagnostic testing may be done for occlusion? | Venogram, Doppler ultrasound, fibrinogen scanning. |
| Discuss risk factors for AAA. | Prolonged, strict bed rest, general surgery, leg trauma, previous venous insufficiency, obesity, oral contraceptives, pregnancy, malignancy. |
| Discuss nursing diagnoses related to AAA. | Acute pain r/t; Ineffective tissue perfusion r/t. |
| What is Heparin used for? | To prevent conversion of fibrinogen to fibrin and prothrombin to thrombin, inhibiting clot formation. Because clotting mechanism is prolonged do not cause tissue trauma, it may lead to bleeding when giving heparin subQ. |
| What must be remembered when giving Heparin subQ? | DO NOT massage area or aspirate; give in the abdomen between the pelvic bones, 2 inches from umbilicus; rotate sites. |
| Discuss nursing plans/interventions with thrombophlebitis. | Administer anticoagulant therapy as prescribed;note sides,esp BLEEDING;monitor labs, note on all labs,PTT;PT/INR,press on venipuncture sites;notify dr unusual bleeding. |
| What unusual bleeding may show up with pt on Heparin? What should RN do? | Abnormal vaginal bleeding, nosebleeds,melena, hematuria, gums, hemoptysis. |
| What safety teaching should RN do in relation to thrombophlebitis? | Side effects of meds, wear med alert;avoid: alcohol,safety razors if on Coumadin,aspirin/asprin products/NSAIDS, increased risk for DVT in future. |
| What actions/lifestyle actions, should RN teach pt with thrombophlebitis? | Bed rest;strict,if prescribed-NO BATHROOM PRIVILEGES!AVOID STRAINING,wearantiembolic stockings,elevate extremity,use shock blocks/foot of bed. |
| What should RN monitor with throbophlebitis? | Pulmonary embolus (chest pain, SOB,),monitor for decreasing symptomatology: pain and edema. |
| What is the antagonist for Heparin? | Protamine sulfate. |
| What labs should be done if on Heparin? | PTT or APTT: determines efficacy;keep 1/5 to 2.5Xnormal control. |
| What Labs should be done if on Coumadin? Why? | PT determines efficacy;1.5-2.5X normal control;INR (international normalized ratio);desirable therapeutic level usually 2-3 seconds(reflects how long it takes a blood sample to clot). |
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