DVT 101
This condition includes both DVT and PE.
Venous thromboembolism (VTE)
Name 2 common risk factors for developing a DVT
Immobility, surgery, cancer, previous DVT/VTE, pregnancy, estrogen therapy, trauma, older age
Name the three components of Virchow’s triad.
Venous stasis, endothelial injury, hypercoagulability.
Name two common findings in an extremity with a DVT.
Unilateral swelling, warmth, tenderness/pain, erythema
What class of medication is commonly used to treat a DVT?
Anticoagulants
Cancer patients are approximately this many times more likely to develop VTE than non-cancer patients?
5-7 times more likely.
Why does prolonged immobility increase DVT risk?
Immobility causes venous stasis.
A patient has been on bed rest for 5 days. Which component is occurring?
Stasis
Would you expect the affected extremity to be warm or cool?
Warm
Why should you not massage an extremity with a suspected DVT?
Manipulation could theoretically dislodge the thrombus; avoid massaging a suspected DVT
What is the preferred diagnostic test for a suspected DVT?
Duplex/compression ultrasound
A patient is 2 days post-op and has been mostly in bed. What two factors increase their DVT risk?
Recent surgery and immobility.
Damage to a blood vessel during surgery represents which component?
Endothelial injury
A patient has unilateral leg swelling, warmth, and tenderness. What condition should the nurse suspect?
DVT
What is the purpose of anticoagulant therapy: dissolve the existing clot immediately or prevent clot extension/new clot formation?
Prevent extension and formation of additional clots while the body gradually breaks down the existing clot
Why does a DVT cause swelling in the affected extremity?
The clot obstructs venous return, increasing venous pressure and causing fluid to move into surrounding tissues
Which patient has a higher DVT risk: one who ambulates frequently or one on prolonged bed rest, and why?
Bed rest because reduced muscle pumping promotes venous stasis
A disorder that makes the blood unusually prone to clotting represents which component?
Hypercoagulability
A patient with a DVT suddenly develops dyspnea and chest pain. What complication should the nurse suspect?
PE
A patient is receiving a continuous IV heparin infusion for a DVT. What laboratory test is commonly used to monitor unfractionated heparin therapy?
aPTT (or anti-Xa depending on institutional protocol)
What is the difference between a DVT and a VTE?
DVT is a clot in a deep vein; VTE is the broader term that includes DVT and pulmonary embolism.
A patient has cancer, recent surgery, and prolonged immobility. Which elements of Virchow’s triad are present?
Stasis from immobility, endothelial injury from surgery, and hypercoagulability associated with cancer.
Give one clinical example of each component of Virchow’s triad.
bed rest = stasis; surgery/trauma = endothelial injury; cancer/pregnancy = hypercoagulability.
A patient with a known DVT suddenly becomes tachycardic, hypoxic, and short of breath. What is the priority concern?
PE
A patient on a heparin infusion begins bleeding from their IV site and gums. What complication should the nurse suspect, and what is the priority nursing action?
Bleeding from anticoagulation; stop/hold the heparin per protocol and immediately notify the appropriate provider/rapidly assess the patient and bleeding severity.