Disorders of the Veins and Arteries
3
to check for areas of swelling, tenderness or discoloration of the skin. The Homan's sign, where a
patient will use dorsiflexion of the ankle with the knee extended which may generate calf pain
will be tested after physical assessment. If the patient has various risk factors that would indicate
DVT, further testing such as doppler ultrasounds or cat scans could be done to verify thrombosis
(Huether & McCance, 2017). Treatment for DVT includes oral blood thinners such as Coumadin
or Eloquis or subcutaneous injection such as Lovenox. Depending on how severe the type of
deep men thrombosis, intravenous drugs known as thrombolytics are given to break up clots
quickly. Filters surgically placed within the veins are also used as measures. Finally, compression
stocking is used to help prevent swelling.
Chronic Venous Insufficiency
Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall and
valves in the leg veins are not working effectively, making it difficult for blood to return to the
heart from the legs (Cleveland Clinic, n.d). This complication can lead to blood "pooling" within
the vein, which causes the blood to leak backward and is known as stasis. This stasis can lead to
the lower extremities developing ulcers.Some risk factors of CVI are obesity, over the age of 50
years, pregnancy, history of blood clots and smoking. Women are more likely to develop CVI
than men. Symptoms of CVI include swelling or heaviness in the legs, pain, itchiness, and vari
-
cose veins. In order to
diagnose CVI,
advanced practitioners must take a health history, complete
a physical examination, and use a serum d-Dimer lab test to rule out DVT are used (Huether &
McCance, 2017). Also, the use of duplex ultrasound is used to check which direction the blood is
flowing. The treatment to CVI is to help reduce and stop swelling of the legs. Compression
stockings are utilized to help reduce the swelling. Lifestyle changes such as increased movement
and exercise can help lower the pressure and improve blood flow in the veins. Some patients

Disorders of the Veins and Arteries
4
may need medications such as diuretics to get rid of the excess fluid in the legs. If a patient’s


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- Spring '15
- Thrombosis, Venous insufficiency