definition
pathophysiology
clinical signs
nursing


definition

    Deep vein thrombosis or phlebitis, is an inflammation of a vein ( atheroma ) most often deep , obliterated by the formation of a clot or thrombus. This clot completely or partially obstructs the light aveine .


pathophysiology

mechanism

The thrombus is formed at a valve, from platelets and white blood cells.
The thrombus can float in the bloodstream is called phlebothrombosis thrombosis, the risk of pulmonary embolism is high.
When the thrombus adheres to the wall , it is called thrombophlebitis .
predisposing factors

Venous stasis : slowing of blood flow to deep capital : plaster, right heart failure , varicose veins of the lower limbs , venous compression , prolonged sitting .
Parietal lesions during alterations of the venous wall , when the lesion is infected, there is inflammation and thus a poor venous return : catheter, infusion aging.
Changes in the blood coagulation abnormality biological , hereditary acquisition amended , taking progestin in women.
complications

Extension of thrombosis to proximal veins.
Pulmonary embolism by the migration of thrombus in the vena cava.
Postphlebitic disease .

clinical signs

initial stage

Dissociation pulse / temperature.
Pain in the lower limb.
Sign Homens : pain caused to dorsiflexion .
Pain along the venous route.
Gravity calf numbness .
Reduction of sloshing calf.
Red calf , hot, tense.
Pitting edema persistence of the trace of the finger.
Paresthesia .
Stage of thrombophlebitis confirmed

Pain all over the tenacious and intense member .
Functional impairment.

nursing

The prevention of phlebitis

Early rise.
Active and passive mobilization : regular and frequent contractions , massages, foot elevation .
Contention Members: increase venous return and thus reduce edema.
Anticoagulant for preventive medical prescription heparin subcutaneously .
treatment

The special care

Strict bed rest due to risk of pulmonary embolism.
Elevation feet.
The heparin treatment with curative intent

Before treatment, you must have a coagulation upstream : PT, APTT , platelet, blood group.
Administration : Early treatment with low molecular weight heparin (LMWH ) and relay with vitamin K antagonists (VKA ) .

Intravenous continuous electric pump .
Subcutaneous : 2-3 calciparine the injection 24 hours.
Subcutaneous : 2 fractionated heparin injection 24 h.
Surveillance:

Proper functioning of the SAP (hourly rate , flow) tubing and fittings .
Assess the risk of bleeding .
Heparinaemia : 0.3 to 0.6 IU / L.
Wafer twice weekly .
Patient Education

Prevent the risk of treatment: minor bleeding risk .
Properties of anti -vitamin K.
Importance of taking daily treatment.
Need for control examination .