Never rub area may dislodge clot Early ambulation or leg exercises best way to

Never rub area may dislodge clot early ambulation or

This preview shows page 23 - 34 out of 37 pages.

Never rub area, may dislodge clot Early ambulation or leg exercises best way to prevent clot from forming
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DVT cont. Treatment IV heparin - GO TO TREATMENT Low molecular weight heparin IVC filter – used to prevent clots Streptokinase, urokinase, or alteplase (t-Pa) – THESE DISOLVE THE CLOTS Supremely high risk of bleeding with these Coumadin (Warfarin) Takes 3 days to build therapeutic level Xarelto, Eliquis Lixiana, Pradaxa (newer anticoagulants) Anticoagulants do NOT dissolve the clot!
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And more DVT Elastic stocking to prevent recurrence TED hose or less commonly Jobst hose Apply in AM SCDs Prevention: Exercise, hydrate, quit smoking, avoid substances that coagulate the blood, and avoid sitting for long periods.
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Thrombosis Whenever a pt has a known thrombosis, monitor for pulmonary embolus, if found it is an emergency Dyspnea Hemoptysis – COUPHING UP BLOOD Tachypnea Chest pain Feeling of impending doom cyanosis
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Embolism Sudden obstruction of an artery by a mass of foreign material through circulation Usually a blood clot broken off from a thrombus Effects of an embolism depend on: Site at which it is lodged Size compared with the caliber of the blood vessel
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Embolism Arterial thrombosis is treated r/t severity Thrombectomy Catheter threaded into the artery and streptokinase or urokinase may used to dissolve the clot Usually done over 36-72hr period IV heparin may also be used to prevent further clotting
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Venous Insufficiency and Varicose Veins: Contributing Factors Obesity Family or personal history of atherosclerosis Trauma Hypertension Smoking Pregnancy Long periods of bedrest Standing for long periods of time Varicose veins: enlarged veins that are distorted in shape by accumulations of pooled blood Leads to incompetent valves that allow reflux of blood from deep veins into superficial veins
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Vericose Veins/Venous Insufficiency Signs and symptoms Dilated, twisted-appearing, superficial vessels Swelling of foot, leg, and ankle especially at the end of the day Legs feeling “full” and “heavy” Include increased pigmentation of the skin, dryness and scaling, and excoriations (scratches) Progression leads to blood leaking into spaces causing deposits of hemosiderin and discoloration of the skin, starting around ankles and shins
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Venous Insufficiency and Varicose Veins: Treatment Elastic support hose Exercise legs and feet periodically throughout the day – walking is ideal exercise Elevate legs whenever possible Weight reduction Behavior modification to reduce risk factors Nonsteroidal anti-inflammatory drugs (NSAIDs), thrombolytics, and anticoagulants Surgery
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Venous Disorders: Surgical Interventions Thrombectomy Sclerotherapy Ambulatory phlebectomy Vein stripping and ligation Veins with multiple, severe varicosities (>4mm) Endoscopic surgery Laser treatment Vena cava filter – KEEP CLOT FROM TRAVELING
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