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Venous Disorders
Vascular Disorders (VENOUS)
| Term | Definition |
|---|---|
| Phlebitis | Inflammation of a superficial vein; NO thrombus Redness, tenderness, warmth, mild edema |
| Phlebitis Treatment (3) | Remove IV catheter Elevate extremity if edema present to promote reabsorption of fluid Warm, moist heat NSAIDs for pain and inflammation |
| Venous Thromboembolism | Thrombus forms in association with inflammation of the vein |
| Superficial vein thrombosis | Formation of thrombus in a superficial vein (e.g., greater or lesser saphenous) Tender, warm, pain, red, inflamed, vein palpable, induration, rubour Can lead to DVT or VTE |
| Deep vein thrombosis | Thrombus in a deep vein (e.g., iliac and femoral) Tenderness to pressure, induration, vein distention, EDEMA, pain, rubour, fever |
| Venous Thromboembolism Etiology and Pathophysiology | Localized platelet aggregation and fibrin: entrap RBCs, WBCs, and more platelets to form thrombus (frequent at valve cusps) Thrombus enlarges, (more blood cells and fibrin) producing larger clot with “tail” Eventually occludes the lumen |
| Virchow’s triad | 1) Venous stasis 2) Endothelial damage 3) Hypercoagulability of blood |
| Venous stasis | Valves DYSFUNCTION or muscles of extremities INACTIVE; often at valve cusps (blood pooling) Risk Factors: Obese or pregnant, chronic HF or Afib, long trips without exercise, prolonged surgical procedure, immobile for long periods |
| Endothelial damage | Stimulates platelet activation and initiates COAGULATION cascade Direct – surgery, intravascular catheterization, trauma, fracture, burns Indirect – chemotherapy, vasculitis, sepsis, diabetes |
| Hypercoagulability of blood | Hematological disorders (polycythemia, severe anemias, malignancies, sepsis) Estrogen-based contraceptives, postmenopausal Smoking |
| Induration | thickening and hardening of soft tissues of the body, specifically the skin |
| Rubour | Redness |
| SVT interventions (8) | Remove IV catheter immediately Ultrasound Anticoagulation (maybe) Oral NSAIDs Graduated compression stockings Warm compresses Elevate affected limb above level of heart Mild exercise, such as walking |
| DVT interventions | Prophylaxis: Mobilization, Change position q2h if on bed rest, Graduate compression stockings or SCDs Medication therapy Anticoagulants (-in) Surgical or interventional therapy: Thrombectomy or thrombolysis, Vena cava filter |
| Varicose Veins | Tortuous subcutaneous veins Superficial veins become dilated and tortuous in response to backflow of blood and increased venous pressure Cause: congenital weakness of the veins or previous VTE |
| Venous Thromboembolism Acute Intervention | Prevent emboli formation and reduce inflammation Blood tests Monitor for bleeding and reduce risk Reverse anticoagulant for: Heparin (Protamine sulfate) and Warfarin (Vitamin K) Early ambulation |
| Varicose Veins Clinical Manifestations and Complications | Discomfort Cosmetic disfigurement Heavy, achy feeling Pain after prolonged standing (relieved with walking or limb elevation) Itchy, burning or cramping sensation in affected leg Swelling Superficial venous thrombosis most frequent complication |
| Chronic Venous Insufficiency and Venous Leg Ulcers | Chronic and acute venous insufficiency results from leg veins and valves FAILING to keep blood moving forward Results in ambulatory venous hypertension Leads to venous ulcers Non-life threatening Painful and debilitating |
| Ambulatory venous hypertension | Serous fluid and RBCs leak from capillaries and venules into tissue Edema and inflammatory changes Enzymes break down RBCs – releases hemosiderin (brown discolouration) Fibrous tissue replaces skin and subcut. tissue Thick, hardened, contracted skin |
| Chronic Venous Insufficiency and Venous Leg Ulcers Clinical Manifestations and Complications | Ulceration No wound healing Stasis dermatitis (Pruritis- itchy skin) Classically located above medial malleolus Ulcers are painful, especially in dependent positions Wound becomes wider, deeper without treatment Increases risk of infection |
| Chronic Venous Insufficiency and Venous Leg Ulcers Interprofessional Care | Compression Activity guidelines and proper limb positioning Moist dressings Nutritional status Monitor for infection |
| Phlebitis risk factors | Mechanical irritation from catheter Infusion of irritating medications Catheter location |
| Venous Thromboembolism Complications | Embolization to lungs (pulmonary embolism) can cause death Pulmonary hypertension and post-thrombotic syndrome +/- venous leg ulceration |
Created by:
selenay15
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