Lecture Notes: Deep Vein Thrombosis (DVT)

Introduction

• Presenter: Christine from Nurse in the Making
• Focus: Deep Vein Thrombosis (DVT) in the cardiovascular section
• Encourage following along with med surg flash cards

Definition of DVT

• Deep Vein Thrombosis (DVT): A clot that typically forms in the lower extremities, most commonly in the calves
• Characteristic: Usually unilateral (found on one side of the leg)

Pathophysiology

• DVT: A clot in the deep vein
• Venous Thromboembolism (VTE): The umbrella term for clots within vessels, including DVT and pulmonary embolism (PE)
• Clot Formation: Disturbs normal blood flow by pooling in one place, potentially blocking or partially occluding blood flow

Risk Factors for DVT

• General Causes: Anything leading to slow and sluggish blood flow
  • Smoking
  • Long periods of sitting (e.g., plane or car travel)
  • Surgery or immobility
  • Sedentary lifestyle
  • Bed rest or paralysis
  • Oral contraceptive use
  • Atrial fibrillation (Afib)

Virchow's Triad

• Venous Stasis: Slow blood flow, caused by bed rest, immobility, travel, or surgery
• Endothelial Damage: Upsets body's baseline (e.g., trauma, surgery, IV drug use)
• Hypercoagulability: Increased risk of clotting (e.g., pregnancy, cancer, oral contraceptives, dehydration)

Signs and Symptoms of DVT

• Unilateral Symptoms: Redness, tenderness, swelling, and warmth in the back of the leg
• Patient History: Important to inquire about past clots and recent travel

Identification and Diagnosis

• Blood Work: D-dimer test (measures protein fragments from a dissolving clot)
  • Elevated D-dimer (>0.5) suggests a clot
• Doppler Ultrasound: Used to locate the clot

Nursing Care and Treatment

• Prevent Clot Dislodgment:
  • DVT Memory Trick:
    • D: Don’t walk, massage, or use heat on the affected leg
    • V: Elevate vein above heart level
    • T: Use anticoagulants to dissolve the clot (e.g., heparin, warfarin)
• Prevention Strategies:
  • Promote ambulation and exercise
  • Use of TED stockings and compression devices to promote blood flow
  • Smoking cessation
  • Obtain adequate history for risk assessment
• Prophylactic Measures:
  • Use of Lovenox or heparin post-surgery or during bed rest to prevent clot formation

Conclusion

• Encourage subscribing to Christine's YouTube channel for more educational content
• Happy studying to future nurses!