Venous disorders

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  1. Acute Venous disorders
    • find self study guide
    • VTE/DVT- thrombophlebitis of deep vein
    • - inc risk women, > 40, hospitalized pts, prior DVT, venous stasis, pregnancy, malignancy
  2. Virschow's triad
    • 2 of 3 must be present for thrombi to form
    • - venous stasis
    • - hypercoag
    • - injury to venous wall
  3. Patho venous
    • damage to venous wall attracts platelets & chemotactic agents, along w/stasis or hypercoag, thrombus
    • platelets adhere to endothelium and form clot
    • valves may be destroyed
    • range from 1mm to big enough to occlude vein
  4. venous management
    • **prevention
    • compression stockings, venodynes
    • meds- ASA, heparin, lovenox
    • active & passive ROM
    • early ambulation
    • no pillows under the knee postop
    • avoid long periods of sitting/standing
  5. Venous manifestations
    • about 1/2 asymptomatic
    • ** localized pain, & unilateral leg swelling
    • redness, warmth
    • dilated veins
    • US venous duplex scanning
    • * first sign may be PE
  6. medical management venous- medical
    • BR 5x 7 days
    • monitor for PE
    • leg elevation about 6"
    • anticoag therapy- heparin, enoxaparin, warfarin (cont 3-6 months)
  7. Nx considerations acute venous
    • goal- prevent existing thrombi from embolizing, prevent new thrombus
    • Monitor PTT, PT/INR, H&H, plt
    • bleeding precautions
    • teach about anticoag
    • analgesics PRN
  8. surgical management- acute venous
    • venous thrombectomy- rarely done
    • umbrella procedure- IVC filter- inserted into IVC to trap large embolism
  9. chronic venous disorders/insuffciency
    • follows most severe cases of DVT 'post thrombotic syndrome'
    • 20% have no history of DVT
  10. patho chronic venous
    • decreased venous return inc pressure, destroys valves and causes venous stasis
    • - inc hydostatic pressure- leakage
    •     hemosiderin
    • flow is now bidirectional
    • very high venous pressure exerted at the ankle
  11. chronic venous manifestations
    • chronically swollen limbs
    • thick, coarse, brownish skin, esp at ankles
    • venous stasis ulcerations
  12. chronic venous management
    • goals- inc venous return, dec pressure
    • elevate legs above level of heart
    • avoid prolong standing or sitting
    • avoid crossing legs, dangling legs, constrictive clothing
    • sleep with FOB eleva 6 "
    • balance diet
  13. chronic venous management
    • graduated pressure stockings
    • antiembolic stockings
    • - review proper fitting
    • smoking cessation
    • good foot care qd
  14. Varicose veins
    • review sheet
    • loss of valvuar cometence & constant high venous pressure can cause distention & tortuosity of superfical veins
    • increased prevalence w/age- peaks 50-60's
    • more common in women until 70 than equal
  15. varicose veins manifestations
    • appearance
    • aching, heavy feeling
    • itching
    • moderate swelling
  16. diagnostic tests- varicose veins
    • note venous pressure changes during walking
    • doppler flowmetry
  17. medical management varicose veins
    • compression stockings
    • teach to avoid prolong sitting/standing, constictive clothing
    • elevate legs 6"
    • walk for exercise
    • wt loss prn
  18. surgical management varicose
    • sclerotherapy
    • vein ligation
    • endovenous laser therapy (EVLT)
    • - shrinks/closes vein with laser
    • - quick, outpatient procedure
    • - 98% success rate

Card Set Information

Author:
Prittyrick
ID:
330160
Filename:
Venous disorders
Updated:
2017-04-06 03:06:16
Tags:
veins
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Description:
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