Nursing Care Plan for Thrombophlebitis / Deep Vein Thrombosis (DVT)

A potential complication of thrombophlebitis and DVT is thrombi can break of and become emboli to other vital organs such as the lungs (PE), heart (MI), or brain (CVA). Monitor for signs of these occurrences.

This is an anticoagulant that prevents worsening of clots or development of new clots. It does not breakdown clots, but allows the body’s natural fibrinolysis to occur without new clots forming.

Monitor aPTT q6h to adjust and maintain therapeutic levels.

Follow your facility protocols for administration of bolus and dosing. Refer to the Pharmacology course for more details of this drug.

Both SubQ and oral anticoagulant therapy are used as prophylactic (prevention) therapy.

Patient will need to have frequent blood draws to monitor their INR if taking Coumadin. Therapeutic range is between 2 and 3.

Follow your facility protocols for administration and dosing. Refer to the Pharmacology course for more details of these drugs.

The sooner you get a patient moving the less likely they are to form anymore blood clots.

Compression socks and SCDs encourage blood flow back to the heart and prevent blood stasis.*Caution – as soon as the patient has a confirmed DVT, ll three of these should be held until an IVC filter can be placed

Vitamin K works to help increase clotting, this is opposite of what we are trying to do for this patient.

The only time Vitamin K is used therapeutically is if the patient is bleeding out, in which case the treatment may be vitamin K with Fresh Frozen Plasma (FFP).

Vitamin K is also the antidote for Coumadin (warfarin)

This monitors for changes in the heart and allows for quick intervention if the clot moves and is stuck in the heart.

This monitors for changes in oxygenation if the clot moves to the lungs.

This isn’t just for in the hospital, it is also for when the patient goes home. The patient is at major risk for bleeding out, thus educating about s/sx of internal bleeding as well as educating about fall precautions is vital.

• GI bleeding: Dark, tarry stool (Upper GI bleed) OR bright red bloody stools (lower GI bleed)
• Epistaxis: Nosebleeds are obvious, however, inform the patient that if they bleed through nasal packing for longer than 15 minutes they should go to the ER. Also they they feel dizzy, faint, or are losing color in their face they should go to the ER.
• Cuts that don’t stop bleeding: if the cut has had pressure applied for longer than 15 minutes and the gauze is being soaked through the patient should go to the ER.
• Brain bleed: Have patients and the people who are around them look for S/Sx such as confusion, facial droop, one sided weakness.

Cornell Note-Taking System Instructions:

1. Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
2. Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
3. Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
4. Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
5. Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.

For more information, visit www.nursing.com/cornell