NAME OF THE SUBJECT: Nursing research and statistics

NAME OF THE TOPIC: Research report writing

NAME OF THE GROUP: BSc nursing 3rd year
VANUE: BSc 3rd year class room
TIME: 4pm to 5pm
DURATION: 1 HRS
NAME OF THE STUDENT TEACHER: MR, Dillipkumar dash
NAME OF THE EVALUATER TEACHER: MR.Asokan. R, Associate. Professor, KINS
PREVIOUS KNOWLEDGE OF THE STUDENT: The students have some knowledge about research.
METHOD OF TEACHING: lecture cum discussion
AV aids: LCD, green board, handouts, poster
GENERAL OBJECTIVES: At the end of the session student will able to gain knowledge on various aspects of research report writing, will develop positive
attitude towards it and will able to write their research report by using this knowledge.

SL NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION

OBJECTIVE ACTIVITY
1 5min 1. Self-introduction
 2.Introduction of the topic
3. Announcement
4 2min Define the topicDEFINITION: Teacher defined the topic; LCD What is the
 Deep vein thrombosis occurs when a blood students nodded their head meaning of deep
clot (thrombus) forms in one or more of the and took the note. vein thrombosis?
deep veins in the body, usually in the legs.
 Venous thromboembolism (VTE)
encompasses deep venous thrombosis
(DVT) and pulmonary embolism (PE) and
causes cardiovascular death and disability.
 In the United States, the Surgeon General
estimates there are 100,000 to 180,000
deaths annually from PE and has declared
that PE is the most common preventable
cause of death among hospitalized patients.
5 2min Enlist the EPIDEMIOLOGY: Teacher enlisted the LCD How many are
epidemiology  Venous Thromboembolism related deaths epidemiology by using LCD risk to death?
3,00,000/anum Students wrote down the
 7% diagnosed and treated definition on their note.
 34% sudden pulmonary embolism
 59% as undected
6 2min Enlist the INCIDENCE: Teacher enlisted the LCD, Black What is the rate
incidence  An annual incidence of symptomatic incidence by using LCD board of
Venous Thromboembolism as 117 per Students wrote down the hospitalization?
100,000 persons. definition on their note.
 Venous Thromboembolism in hospitalized
patients has increased from 0.8% to 1.3%
over a period of 20 years (reported in
2005).
7 2min Describe the ETIOLOGY: Teacher described the poster Where is the calf
etiology Starts in lower extremity calf vein etiology, students nodded vein?
their head and took the note.

progressing proximally to involves

popliteal, femoral, iliac system

8 3min Narrate the VIRCHOW TRIAD: Teacher Narrated the pamplet What is venous
virchow triad More than 100 years ago, rudolf virchow virchow triad and students stasis?
described three triad factors of deep vein listened carefully.
thrombosis.

Venous stasis

Hypercoagulable state Endothelial

damage
9 10min Explain the PATHOPHYSIOLOGY: Teacher explained the Leaf let How will you
pathophysiolog Reduced blood flow :Venous stasis occurs when pathophysiology and differentiate
y blood flow is reduced, when veins are dilated, students listened carefully damage and
and when skeletal muscle contraction is by taking notes phlebitis?
reduced.

Damage: Damage to the intimal lining of blood

vessels creates a site for clot formation.

Phlebitis: Formation of a thrombus frequently

accompanies phlebitis, which is an
inflammation of the vein walls.

Platelet aggregates Venous thrombi are

aggregates of platelets attached to the vein wall
that have a tail-like Appendage containing
fibrin, white blood cells, and many red blood
cells.

Tail The “tail” can grow or can propagate in the

direction of the blood flow as successive layers
of the thrombus form
 Fragmentation Fragmentation of the thrombus
can occur spontaneously as it dissolves
naturally, or it can occur with an elevated
venous pressure.

Recanalization After an acute episode of DVT,

Recanalization or reestablishment of the lumen
of the vessel typically occurs.
10 5min List out the CLINICAL MANIFESTATION: Teacher list outed the LCD, white What is edema?
clinical Edema clinical manifestation by board
manifestation Tenderness lecture cum discussion
Pulmonary embolus method and students
Phlegmasia cerulea dolens listened carefully.
11 2min Describe the CLINICAL EXAMINATION: Teacher described the LCD What is lintons
clinical  Neurologic evaluation may detect nerve clinical examination by sign?
examination root irritation; sensory, motor, and reflex lecture cum discussion
deficits should be noted. method and students
 Lintons sign: After applying torniquet at listened carefully.
saphenofemoral junction patient made to
walk , then limb is elevated in supine
posation prominent superficial veins will be
observed.
12 2min Enlist the DIAGNOSTIC STUDIES: Teacher enlisted the Chart What is d dimer
diagnostic  Clinical examination alone is able to diagnostic studies by using test?
studies confirm only 20-30% of cases of DVT LCD Students wrote down
 Blood Tests The D-dimer the definition on their note.
 Imaging Studies
13 10min Describe the MEDICAL MANAGEMENT: Teacher described the LCD What is medical
medical The objectives for treatment of DVT are to medical management by management?
management prevent thrombus from growing and lecture cum discussion
fragmenting, method and students
Recurrent thromboemboli, and post thrombotic listened carefully.
syndrome.
Endovascular management: Endovascular
management is necessary for dvt when
 anticoagulant or thrombolytic therapy is
contraindicated, the danger of pulmonary
Embolism is extreme, or venous drainage is so
severely compromised that permanent damage
to the extremity is likely.
EMERGENCY DEPARTMANT CARE:
The primary objectives of the treatment of DVT
are to -
 prevent pulmonary embolism,
 reduce morbidity, and
GENERAL THERAPEUTICMEASURES:
 Bed rest
 Encourage the patient to perform gentle
foot & leg exercises every hour.
SPECIFIC TREATMENT:
 Anticoagulation
 Thrombolytic therapy for DVT
14 5min Explain the PHARMACOLOGIC THERAPY: Teacher explained the White board What is
pharmacologica ANTICOAGULATION: pharmacological therapy by anticoagulant?
l Heparin prevents extension of the thrombus lecture cum discussion
managemement It is a heterogeneous mixture of polysaccharide method and students
s fragments with varying molecular weights but listened carefully.
with similar biological activity.
DOSE:
IV bolus dose of 5,000 to 10,000 units followed
by an infusion of 1,000 units per hour. Other
method of initiating therapy is to begin with
loading dose of 50-100 units/kg of heparin
followed by a constant infusion of 15-25
units/kg/hr.
SIDE EFFECTS:
 Bleeding
 Osteoporosis
 Thrombocytopenia
 Skins lesions- papules, necrosis
CONTRAINDICATIONS:
 Bleeding disorders,
  Severe hypertension,
 threatened abortion, piles,
LOW MOLECULAR WEIGHTHEPARIN:
 Selectively inhibit factor Xa .
 Superior bioavailability
 Superior or equivalent safety and efficacy
 Subcutaneous once- or twice-daily dosing
WARFARIN:
 Interferes with hepatic synthesis of vitamin
K- dependent coagulation factors
 Dose must be individualized and adjusted to
maintain INR between 2-3
 Oral dose of 2-10 mg/d
Indications:
 when anticoagulant therapy is ineffective
 unsafe,
 contraindicated.
The major surgical procedures for DVT are clot
removal and partial interruption of the inferior
vena cava to prevent pulmonary embolism.
These pulmonary emboli removed at autopsy
look like casts of the deep veins of the leg
where they originated.
 THROMBECTOMY.
 CATHETER-DIRECTED
THROMBOLYSIS
 FIRST-GENERATION PCDT
 NEW: SINGLE-SESSION
PCDTPowerPulse Isolated Thrombolysis
 FILTERS FOR DVT
15 5min Describe the NURSING MANAGEMENT: Teacher described the LCD What is nursing
nursing Assessment of a patient with deep vein nursing management by management?
management thrombosis includes: lecture cum discussion
 physical examination method and students
 Well’s diagnostic algorithm, Because of the listened carefully.
unreliability of clinical features, Well’s
diagnostic algorithm has been validated
 whereby patients are classified as having a
high, intermediate, or low probability of
developing DVT.
NURSING DIAGNOSIS:
1. Ineffective tissue perfusion related to
interruption of venous blood flow.
2. Impaired comfort related to vascular
inflammation and irritation.
NURSING INTERVENTION:
The major nursing interventions that the nurse
should observe are:
1. Provide comfort: Elevation of the affected
extremity, graduated compression
stockings, warm application, and
ambulation are adjuncts to the therapy that
can remove or reduce discomfort.
2. Compression therapy: Graduated
compression stockings reduce the caliber of
the superficial veins in the leg and increase
flow in the deep veins; external
compression devices and wraps are short
stretch elastic wraps that are applied from
the toes to the knees in a 50% spiral
overlap; intermittent pneumatic
compression devices increase blood
velocity beyond that produced by the
stockings.
16 2min Explain the HOME CARE AND FOLLOW UP: Teacher explained the home LCD What are the drug
follow up care The nurse must also promote discharge and care and follow up by education?
home care to the patient. lecture cum discussion
 Drug education: The nurse should teach method and students
about the prescribed anticoagulant, its listened carefully.
purpose, and the need to take the correct
amount at the specific times prescribed.
 Blood tests: The patient should be aware
that periodic blood tests are necessary to
determine if a change in medication or
 dosage is required.

17 2min Summarize the SUMMARY: The student teacher summarizes LCD
topic Deep vein thrombosis (DVT) is the formation of the topic
a blood clot in a deep vein, most commonly in
the legs or pelvis. Symptoms can include pain,
swelling, redness, and enlarged veins in the
affected area, but some DVTs have no
symptoms. The most common life-threatening
concern with DVT is the potential for a clot (or
multiple clots) to detach from the
veins (embolize), travel through the right side of
the heart, and become stuck in arteries that
supply blood to the lungs. This is
called pulmonary embolism (PE).
18 2min Conclude the CONCLUSION: The student teacher concludes the LCD
topic Deep vein thrombosis (DVT) is a serious topic
condition that occurs when a blood clot forms in
a vein located deep inside your body. A blood
clot is a clump of blood that's turned to a solid
state. Deep vein blood clots typically form in
your thigh or lower leg, but they can also
develop in other areas of your body.
BIBLIOGRAPHY:
 Lippincott,textbook of manual of nursing practice, new delhi;wolters kluwer publication,10th edition, 2014, pp-100-101.
 Suddarth and brunner’s, textbook of medical surgical nursing, wolters kluwer publication, 13th edition, page no842-845.
 M. black, joyce. Medical Surgical Nursing. New delhi; Elsevier publication, 8th edition, vol. volume–2, pp- 1331-1335.
 Davidson’s. Principles and practice of medicine. London; Elsevier publication, 21th edition, pp- 717-720.

 Rana nurse practitioner in critical care Follow, pankaj. (n.d.). Deep vein thrombosis (DVT). SlideShare. https://www.slideshare.net/pankajrana87/deep-
vein-thrombosis-dvt-127703104.

 Patil Follow, A. (n.d.). Dvt. SlideShare. https://www.slideshare.net/cshekharg/dvt.

 Deep vein thrombosis. Physiopedia. (n.d.). https://www.physio-pedia.com/Deep_Vein_Thrombosis.