Phlebothrombosis Concept map

Legend:

Disease Process

Predisposing Factors

Precipitating Factors

Disease and Definition

Complications

Nursing Diagnosis

Nursing Assessment
References
Nursing Interventions
Predisposing Factors
Sign & Symptoms Precipitating Factors Azole, I. (2021). PHLEBOTHROMBOSIS. - ppt download. Retrieved 25 October 2021, from
Sex
Patient Outcomes
Age Surgery https://slideplayer.com/slide/12104675/ 
Pregnant and postpartum women Medication
Laboratory tests Personal history of Hospital stay
Phlebothrombosis Smoking  Frisk, C. (2012). Bacterial and Fungal Diseases. The Laboratory Rabbit, Guinea Pig, Hamster,
Pharmacologic Therapy Immobility i.e. prolonged bed Virchow's triad (venous stasis,
rest, sitting, inactivity hypercoagulation, and damage)
And Other Rodents, 797-820. doi: 10.1016/b978-0-12-380920-9.00030-4  
Medical Management Clotting disorders

Pathogenesis line Wells scor, H. (2021). By: abdulkrim al-kharashi naif alsikan - ppt video online download.

Connecting line
Retrieved 25 October 2021, from https://slideplayer.com/slide/6037102/

Kong, L. (2014). Thrombophlebitis. Retrieved 25 October 2021, from

https://www.slideserve.com/lixue/thrombophlebitis

Signs and Symptoms

Vessel trauma
stimulates the clotting Pieces of thrombus may
Inflammation is triggered,
Pain cascade break loose and travel
causing tenderness,
Edema through circulation -->
swelling
Positive palpation maneuvers Embolus

- Homan's sign (+)

- Lowenber's sign (+)

Platelets aggregate at the site
particularly when venous stasis is
Enlarged superficial collaterals present Repeated small
Change of skin color and embolisation
temperature (cyanosis)

Platelets and fibrin Post-phlebitic syndrome

form the initial clot

Chronic venous
insufficiency

Anticoagulation Therapy. Initial treatment is RBC are trapped in

with low molecular weight heparin or the fibrin meshwork
unfractioned heparin for at least 5 days,
followed by warfarin for at least 3 months

The thrombus propagates in the

Thrombolytics. To dissolve an existing clot direction of the blood flow
Nonsurgical Management
such as IV streptokinase

Duplex venous ultrasound

Analgesics. Pain medications

Venography

Phlebothrombosis Blood Tests (CMP, CBC, D-

A condition of venous thrombosis without Dimer Test)
inflammation; occurs much more immediately, and
pain is not a prominent feature
Inferior vena cava filter. Only when anticoagulant is Magnetic Resonance
contraindicated; this prevents clots that can break loose Imaging (MRI)
in the legs and travel to the lungs

Computed tomography
(CT) scan

Surgical ligation and stripping. High ligation of the long

saphenous vein at the saphenofemoral junction together Surgical Management
with ligation of all tributaries

Venous thrombectomy. The surgical removal of a vein

clot; only in very serious cases

    Impaired gas exchange Impaired skin integrity

Risk for Bleeding

Nursing Assessment Nursing Assessment

Nursing Assessment
Assess the characteristics of ulcers:
Assess level of consciousness
Assess signs and
and changes in mentation
Location
symptoms of bleeding.
Auscultate lungs for areas of Tissue bed
decreased and absent breath Monitor Heparin-
induced platelet Surrounding tissue
sounds and the presence of
aggregation (HIPA)
adventitious sounds (crackles).
status.

Nursing Intervention Nursing Intervention

Nursing Intervention Elevate the leg as per the
Provide oxygen therapy with an
appropriate method as ordered. physician’s advice.
Administer anticoagulant therapy Keep the skin clean and well
Provide supplemental
as per physician’s advice
humidification, such as lubricated
(continuous IV heparin/low
ultrasonic nebulizers. Avoid possible injury even in
molecular weight heparin).
Keep the head of bed elevated. ambulation
If bleeding occurs when the Clean the wound with non-
Encourage coughing, deep
patient is on heparin therapy:
breathing exercises, and toxic cleaner or normal saline
Stop infusion.
suctioning as indicated.
Assist with frequent changes of
position, and encourage
ambulation as tolerated.
Patient Outcomes
The patient will have intact skin
Patient Outcomes without signs of infection. 
Patient Outcomes The patient maintains a
Client will demonstrate therapeutic level of blood
adequate ventilation and coagulation bleeding.
oxygenation by ABGs within The patient does not
client’s normal range.
experience bleeding. 
Client will report or display
resolution or absence of
symptoms of respiratory
distress