Term
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Definition
1. Circulatory Stasis
2. Vascular damage
3. Hypercoagulability |
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Term
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Definition
| a condition in which a blood clot forms and blocks one or more veins |
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Term
| superficial thrombophlebitis |
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Definition
| when a blockage occurs near the skins surface |
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Term
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Definition
| when a blockage occurs deep in a muscle. Usually occurs in the large veins of the lower leg and thigh |
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Term
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Definition
| a clot that forms in a vein or artery |
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Term
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Definition
| a clot that is formed in a vein |
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Term
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Definition
1. Orthopedic procedures
2. Atrial fibrillation
3. Acute myocardial Infarction
4. Ischemic Stroke |
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Term
| Factors associated with Venous Thrombosis |
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Definition
-Immobilization: MI, heart Failure, stroke, postoperative
-Surgery- orthopedic, thoracic,abdominal, genitourinary
-Cancer- pancreatic, lung, ovary, testes, urinary tract, breast, stomach
-Trauma- fractures of the spine, pelvis, femur, tibia, spinal cord injury
-pregnancy and delivery
-hormone therapy, oral contraceptives, hormone replacement therapy
-coagulation disorders |
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Term
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Definition
-often asymptomatic
-dull aching pain in affected extremity, especially when walking
-possible tenderness, warmth, and erythema along affected vein
-edema of affected extremity
-cyanosis of affected extremity |
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Term
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Definition
Duplex venous ultrasonography
plethysmography
MRI
Ascending contrast venography |
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Term
| Duplex venous ultrasonography |
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Definition
| noninvasive test used to visualize the vein and measure the velocity of blood flow in the veins. Although the clot often cannot be visualized directly its presence can be inferred by an inability to compress the vein during the examination |
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Term
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Definition
| a noninvasice test that measures changes in blood flow through the veins. It is often used in conjunction with Doppler ultrasonography. Plethysmography is most valuable in diagnosing thromboses of larger or more superficial veins. |
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Term
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Definition
| noninvasive means of detecting DVT. It is particularly useful when thrombosis of the vena cava or pelvic veins is suspected |
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Term
| Ascending contrast venography |
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Definition
| uses an injected contrast medium to assess the location and extent of venous thrombosis. Although invasive expensive and uncomfortable, contrast venography is the most accurate diagnostic tool for venous thrombosis. It is used when the results of less invasive tests leave the diagnosis unclear |
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Term
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Definition
| Surgical removal of a blood clot from the femoral vein to prevent pulmonary embolism or gangrene. |
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Term
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Definition
| anticoagulants- include heparin, warfarin, low molecular weight heparins, direct thrombin inhibitors and factor Xa inhibitors |
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Term
| Anticoagulants that prevent clot propagation and enable the body's own lytic system to dissolve clots are the mainstay of treatment for venous thrombosis. |
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Definition
| Thrombolytic drugs like streptokinase or tissue plasminogen activator (tPA) may accelerate the process of clot lysis and prevent damage to venous valves. Thrombolytic therapy may be recommended to dissolve a blood clot. |
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Term
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Definition
| NSAIDs like indomethacin (Indocin) or naproxen (Naprosyn) may be ordered to reduce inflammation in the veins and provide symptomatic relief, particularly for patients with superficial venous thrombosis. |
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Term
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Definition
| patients with DVT, anticoagulation is initiated with unfractionated heparin, LMWH may also be used. Following an initial IV bolus of unfractionated heparin, additional units are infused over a 24 hour period. The dosage is calculated to maintain the aPTT at approximately twice the control or normal value. An infusion pump is used to deliver the prescribed dosage. Frequent monitoring of the infusion is an important nursing responsibility. Subcutaneous heparin injections may be used as an alternative to IV infusion in some instances. |
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Term
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Definition
| oral warfarin may be initiated concurrently with heparin therapy. Overlapping heparin and warfarin therapy for 4-5 days is important because the full anticoagulant effect of warfarin is delayed. Warfarin doses are adjusted to maintain an INR greater than 2.0. Once this level has been achieved the heparin is discontinued and a maintenance dose of warfarin is prescribed to prevent recurrent thrombosis. Anticoagulant therapy is generally continued for at least 3 months. |
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Term
| Low-molecular weight heparin |
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Definition
| Used to treat and prevent venous thrombosis. These medications are more effective and carry lower risks for bleeding and thrombocytopenia than conventional unfractionated heparins. LMWHs are administered subcutaneously in fixed doses once or twice daily, which makes them appropriate for both inpatient and outpatient treatment. |
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Term
| Safety Alert for supplements with anticoagulant therapy |
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Definition
| some foods and supplements can increase the risk of a bleeding episode for patients on anticoagulant therapy. Patients should avoid ginger, garlic, green tea, and ginko while taking heparin or warfarin. |
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Term
| Direct thrombin inhibitors |
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Definition
| These inactivate both free and bound thrombin. USes of the drugs are limited by the FDA to specific situations. Bivalirudin and argatroban are given to patients undergoing percutaneous coronary intervention as well as patients at risk for thrombocytopenia related to heparin therapy. Desirudin is used to prevent DVT in patients undergoing hip replacement surgery, and dabigatran is given to patients with atrial fibrillation and or patients who have received parenteral anticoagulants for 5-10 days. |
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Term
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Definition
| May be used on an outpatient basis to prevent and treat DVT, as well as to reduce the risk of clots and stroke in patients with atrial fibrilation. Are given by mouth and present a lower risk of interaction with food or other drugs and do not need frequent INR monitoring. Rapid discontinuation without substitution of another anticoagulant may lead to serious ischemic events. These drugs should not be used in patients who are undergoing neuroaxial anesthesia or spinal puncture because they increase the risk of long term paralysis due to epidural or spinal hematoma. |
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Term
| Non-pharmacologic therapy |
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Definition
| with superficial venous thrombosis, apply warm moist compresses over the affected vein, resting the extremity and using antiinflammatory agents. Bedrest may be ordered for a patient with a DVT. Elevate legs 15-20 degrees with the knees slightly flexed above the level of the heart to promote venous return and discourage venous pooling. When permited walking is encouraged as is avoiding prolonged standing or sitting. Crossing the legs also is avoided as are tight fitting garments or stockings that bind. |
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Term
| Safety alert for nonpharmacologic therapy |
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Definition
| Elastic antiembolism stockings or pneumatic compression devices are contraindicated in patients with known DVT but they are frequently ordered by physicians for use in the prevention of DVT's. These devices stimulate the muscle pumping mechanism that promotes the return of blood to the heart, therefore they may dislodge a thrombus and cause a PE. |
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