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Deep Vein Thrombosis (DVT) or Venous Thromboembolism (VTE) - Coggle Diagram
Deep Vein Thrombosis (DVT) or Venous Thromboembolism (VTE)
Things that put our Ptt at risk for DVT
Stasis
Vessel wall injury
Hypercoagulation
Vocab
Embolism
When a clot comes off the vessel and becomes mobile
Thrombosis
A clot attached to the vessel wall
Risk Factors
Tobacco use
^ age
Hx. of DVT
Oral contraceptive use
Issues with mobility
Cancer (any type)
Clinical Manifestations
Edema
Usually in a leg, one is larger than the other
Pain
Low grade temp
Homens sign - not reliable
Orthopedic surgery
Chronic HF
Varicose Veins
Localized warmth and tender
Prevention
Compression Stockings
Monitor in case they role down
Ptt's often complain they are hot and uncomfortable
Ambulation
Prevent dehydration
Sequential compression device
No crossing legs in bed
Anoxaparin
One mg/kg, max of 90 mg per dose
Usually given in the "love handles", never in arms or abdomen
Joint Commission's VTE Core Measure
Requires hospitals to screen ptt for risk factors of DVT
Drug therapy
Vitamin K antagonists
Ex Warfarin
Longer acting
Monitor INR
Normal 0.9-1
Therapeutic levels should be 1.5-2 x the control
Affects last longer, given once every 24 hours
Antidote = vit K
Lots of interactions w/ other meds
Do not change the amount of vit K you consume (leafy greens)
Avoid high risk activity
Thrombin Inhibitors / Indirect thrombin inhib
Ex
Unfractionated heparin
LMWH (low molecular weight heparin)
Route = IV
Shorter half life
APTT 1.5-2 times control
Antidote = protaminsulfate
Avoid high risk activity
Factor Xa inhibitor
Ex
Apixaban
Rivaroxaban
Oral anticoag
No labs needed
Patient ed
Take pills at same time every day
Talk to doc before starting dietary supplements
Check interactions before starting any new prescriptions or OTC
Tell all docs, dentists, etc that you are on these meds