What is Deep Vein Thrombosis (DVT)?

A formation of a thrombus in association with inflammation in deep veins; most often occurs in the lower extremities of a postoperative patient (Lemone, Burke, Bauldoff, 2011). May form in the upper extremities.

What are the major risk factors? According to the National Institute of Health: A history of DVT. Conditions or factors that make your blood thicker or more likely to clot than normal. Taking hormone therapy or birth control pills. Injury to a deep vein from surgery, a broken bone, or other trauma. Slow blood flow in a deep vein due to lack of movement. Pregnancy and the first 6 weeks after giving birth. Recent or ongoing treatment for cancer. A central venous catheter. Older age. Being older than 60 is a risk factor for DVT, although DVT can occur at any age. Overweight or obesity. Smoking. Why should I be concerned? According to the Centers for Disease Control and Prevention (CDC) some 200,000-400,000 people in the United States develop DVT each year (Anthony, 2013). It is a nursing responsibility to prevent venous stasis.

What are some nursing interventions to help prevent DVTs? (Lemone, Burke, Bauldoff, 2011) Early ambulation after surgery is essential (when possible) Assuring that anticoagulants are available for at risk patients (such as heparin) Use of leg compression devices (electric compression devices and stockings) Regular assessment of pulses

How can a nurse assess patients for DVTs? Observe for swelling, warmth, erythema, and pain of the affected extremity. (Unfortunately, these symptoms are found in many conditions and are not exclusive to DVT) (Anthony, 2013). Also, cramping. Lemone, Burke, Bauldoff, 2011, specifically stated that a positive Homans Sign is a possible indicator for a DVT, however, Anothony, 2013 asserted Homans sign has been used to screen for DVT, but it is positive in 50% or fewer of persons with possible DVTHomans test lacks both sensitivity and specificity, and thus is of no clinical value.

Are there test to confirm my suspicion of DVT? According to the National Institute of Health: The most common test: Ultrasound. This test uses sound waves to create pictures of blood flowing through the arteries and veins in the affected leg. D-dimer test: measures a substance in the blood that's released when a blood clot dissolves. If the test shows high levels of the substance, you may have a deep vein blood clot. Venography: if an ultrasound doesn't provide a clear diagnosis. For venography, dye is injected into a vein in the affected leg. The dye makes the vein visible on an x-ray image. The x ray will show whether blood flow is slow in the vein.

Consequences of DVTs A part of the embolus may break off and travel to the heart, brain, and/or lungs. The clot may also prevent blood flow to the distal portion of the affected limb.

References: Anthony, M., (2013). Nursing assessment of deep vein thrombosis. MEDSURG Nursing, 22(2), 95-123. LeMone, P., Burke, K., & Bauldoff, G. (2011). Medical-surgical nursing: Critical thinking in patient care (5th ed.). Boston, MA: Pearson. National Institute of Health, (2011). What is deep vein thrombosis? Retrieved from http://www.nhlbi.nih.gov/health/health-topics/topics/dvt/