Nursing Interventions for Thrombosis Prevention

Superficial Vein Disease (SVD)

• Involves blood clots in superficial veins located just under the skin.
• Symptoms include swelling, tenderness, redness, warmth, pain during walking, and a palpable hardened vein.

Deep Vein Thrombosis (DVT)

• Forms blood clots within deep veins, commonly in the femoral, saphenous, or popliteal veins.
• Can lead to leg swelling (>2 cm compared to the unaffected leg) and symptoms like fever, chills, and tachycardia.
• Manifestations include tenderness, stiffness, affected leg warmth or pallor, and positive Homan’s sign indicating DVT.

Therapeutic Management for DVT

• Bed rest with affected leg elevated; apply mist heat to reduce discomfort.
• Utilize bed cradles to keep bedclothes off the affected leg, minimizing pressure ulcers.
• Administer heparin as an anticoagulant to prevent clotting; contraindicated with skin massage over clots.
• Monitor laboratory parameters: APTT (40-60 seconds) or prothrombin time.

Nursing Interventions

• Promote ambulation and elevate lower extremities to prevent thrombus formation.
• Mitigate pressure on popliteal area in obstetric stirrups; use proper stirrup height.
• Implement range of motion exercises for those unable to ambulate; avoid pillows under knees to prevent blood pooling.
• Encourage use of anti-embolism or elastic support stockings for the first two weeks post-birth.

Education for Anticoagulant Therapy

• Instruct patients to report any bleeding signs, such as bruising, hematuria, or hematochezia.
• Adjust medication schedule and avoid over-the-counter drugs unless confirmed safe.
• Limit vitamin K intake (e.g., from broccoli, cabbage) when on warfarin therapy.
• Femoral thrombophlebitis symptoms can resolve within days, but complete recovery may take 4 to 6 weeks.

Thromboembolism Terms

• Thrombus: A stationary blood clot formed in a vessel.
• Embolism: A clot that travels and causes blockage elsewhere in the body.
• Phlebitis: Inflammation of blood vessel linings.
• Thrombophlebitis: Combination of inflammation and clot formation in veins.

Etiology and Predisposing Factors

• Venous stasis, increased fibrinogen levels, and pregnancy pressure can increase thrombosis risk.
• Risk factors include inactivity, obesity, cesarean delivery, smoking, a history of previous thrombosis, diabetes, and advanced age (>35 years).
• Dehydration and prolonged immobility also heighten risk.

Examination Topics

• Post-partum complications including thrombophlebitis and pulmonary embolism.
• Newborn complications related to gestational age, such as respiratory distress and jaundice.
• Nursing skills such as Leopold's maneuver, fundic height measurement, and Apgar scoring.

This quiz covers essential nursing interventions for preventing thrombus formation, particularly focusing on monitoring activated partial thromboplastin time (APTT) and prothrombin time (PT). It includes strategies such as ambulation, elevating extremities, and proper positioning to reduce pressure on critical areas. Test your knowledge on best practices in nursing care for thrombus prevention.