hey there future nurses it's christine from nurse in the making and today we're going to talk about dvts if you're following along with your med surg flash cards i'm in the cardiovascular section on the card dvt before we dive in don't forget to subscribe to my youtube channel for weekly videos daily nursing school questions and all things to help you pass nursing school deep vein thrombosis or dvt is a clot which typically forms in the lower extremities we can see them anywhere but most commonly they're seen in the calves they're almost always unilateral and that means exactly what it sounds they're only found on one side of the leg typically but before we dive into the details let's talk about the pathophysiology of what a deep vein thrombosis is a dvt is a clot in the deep vein which sits under the umbrella of a vte which stands for venous thromboembolism or a clot within a vessel dvt and pe both fall under this umbrella term of vte when any clot occurs normal blood flow is disturbed by the collection or pooling of blood in one place the clot that forms can fully block or partially occlude blood flow either way once it forms we have a problem dvts can form in anybody but there are a few factors which can increase someone's chance of developing a dvt think of anything which equals slow and sluggish blood flow this can be caused by smoking long periods of sitting or traveling on a plane or in a car surgery where the whole body is stationary for a long period of time a sedentary lifestyle being bed bound being on bed rest or being paralyzed the use of oral contraceptives also increase your chances of developing a dvt a memory trick here is estrogen think emboli afib because this causes a chaotic rhythm which completely disrupts blood flow and can create a clot or dislodge a clot again there are many factors but these are the most commonly seen in fact there's something called verchow's triad think of this little triangle as a perfect garden with ideal soil for a dvt plant to grow there are three parts to this triad the first is venous stasis or the stagnant or slowing of blood again this is caused by bed rest immobility traveling or surgery the second thing is endothelial damage or basically anything that upsets the body's baseline and invasive way this can be things like trauma surgery iv drug use and indwelling devices hyper coaguability or an increased risk of clotting you want to think pregnancy cancer oral contraceptive use or dehydration a good way to remember this is anything that causes the blood to be sticky so now that we've reviewed these risk factors what are the signs and symptoms of a dvt dvt can sometimes be a bit sneaky which makes them even more dangerous than they already are so if a patient has unilateral remember one-sided redness tenderness swelling or warmth to the back of the leg this should raise a red flag in your nursing mind if a patient complains of any of these things or exhibits any of these signs ask about their history you want to ask if they've had any class in the past any recent travel this is all useful information to know and share when you notify the hcp now let's talk about how you identify this clot blood work will usually be ordered and we'll be looking at that d-dimer result d-dimer measures the amount of protein fragment present in your blood from a dissolving clot an elevated d dimer or anything greater than 0.5 usually means a clot is suspected in the body so the d dimer test tells us there's a clot in the body but it doesn't tell us exactly where that clot is so we use a doppler ultrasound to locate where exactly the clot is and then treatment can start okay so we know this patient has a clot well what do we do as a nurse it's absolutely vital to know and to take care of a patient with a dvt if the clot dislodges or travels it can head straight to the lungs causing a pulmonary embolism this is life-threatening and we definitely don't want this to happen keep the memory trick dvt in mind d stands for don't walk don't massage the leg and don't use heat walking massaging and leg exercises can dislodge the clot and we know what he does to the vessels it opens them up meaning that clot was just given a great opportunity and lots of space to head straight to the lungs v stands for elevate vein issues above the level of the heart lots of v's for dvts this helps with swelling and minimizes pressure and blood flow to the area t stands for anti-coagulants to terminate a clot we need to dissolve it some examples of anticoagulants are heparin and warfarin i have an entire video covering the similarities and differences of heparin and warfarin there should be a link popping up right here if you want to go watch that clots are never something we want sitting in the vessels so we do our very best to prevent them prevention is much different than treatment because it does involve moving around and getting that blood flow to prevent it from slowing and pooling you'll see ted stockings used and compression devices both of these things promote blood flow ambulation and exercise is for the same reason we want to get that blood flow moving we also encourage our patients to stop smoking because we know the negative impacts this can have on the vessels in our body and again make sure you're obtaining an adequate history if someone is at risk things like their travel history history of a clotting disorder and atrial fibrillation all of these can play a part in developing a dvt after surgery or for bed rest patients lovenox or heparin may be ordered prophylactically this means prevention of a clot simply because they're at risk for developing them if you found this video helpful don't forget to subscribe to my youtube channel happy studying future nurses you