Introduction

Thrombophlebitis is a circulatory condition that

occurs when a blood clot, which developed due to a
venous inflammation, inhibits the blood flow. Most
commonly, thrombophlebitis affects the superficial
veins of the extremities (arms and legs). Related
conditions that may be used as a synonym are
phlebitis, phlebothrombosis, and venous thrombosis.
The word is compounded of the term "thrombus",
which describes a blood clot that was formed inside a
blood vessel, and "phlebitis", which is the medical
term for the inflammation of a vein.
It is an inflammatory process that causes a blood
clot to form and block one or more veins, usually in
the legs. The affected vein might be near the surface
of the skin (superficial thrombophlebitis) or deep
within a muscle (deep vein thrombosis, or DVT).
Causes of thrombophlebitis include trauma, surgery or
prolonged inactivity. DVT increases the risk of serious
health problems. It's usually treated with blood-
thinning medications. Superficial thrombophlebitis is
sometimes treated with blood-thinning medications,
too.
 Pulmonary embolism occurs when the pulmonary
artery is obstructed by a blood clot that breaks off and
lodges in the lungs. It may have dramatic signs and
symptoms, such as sudden chest pain, cough,
dyspnea, a decreased level of consciousness, and
signs of heart failure. Although thromboembolic
disorders occur in less than 1% of all postpartum
women, pulmonary embolism can be fatal if a clot
obstructs the lung circulation; thus, early
identification and treatment are paramount. Nursing
management focuses on preventing thrombotic
conditions, promoting adequate circulation if
thrombosis occurs, and educating the client about
preventive measures, anticoagulant therapy, and
danger signs.

Anatomy and Physiology

Lower limb veins are split into two regions the

superficial region, which consists of two saphenous
veins, internal and external, as well as their tributaries,
and the deep region, which consists of veins that are
satellites of the arteries Connecting or perforating
veins and the arches of the two saphenous veins
connect the two networks Valvules are present in the
venous network beneath the meumnal linament, and
their number dimuushes as one gets closer to the
inferior vena .
 Treatment

Treatment of thrombophlebitis which occurs in

the puerperium, can be divided as follows: (1)
preventive measures; (2) avoidance of pulmonary
embolism; (3) management during the acute phase of
the disease; (4) prevention of late effects, namely,
those owing to chronic venous insufficiency of the
affected limb. This paper is concerned solely with
treatment of postpartum thrombophlebitis which
affects the lower extremities. It is probable that a
certain amount of venous thrombosis of the uterine
veins occurs coincidentally with nor- mal involution of
the uterus and that it is of no clinical significance. In
certain cases, particularly if puerperal sepsis and
pelvic cellulitis are present, septic uterine
thrombophlebitis extends to the internal iliac veins
and is the source of pyemia or of infection
disseminated throughout the body. In other cases,
abnormally extensive thrombophlebitis involves the
veins of the broad ligament, produces pelvic
symptoms and can be recognized clinically. However,
thrombophlebitis that involves uterine and internal
iliac veins may be recognized only at necropsy.
 Prevention of postpartum thrombophlebitis of the
lower extremities involves consideration of the factors
responsible for it. Little progress in elucidating these
factors has been made in the past thirty-five years.
Theoretically, as in other types of thrombophlebitis,
there are three factors, namely, some local lesion of
the intima of the vein, disturbance of the clotting
mechanism of the blood and venous stasis. It is
possible that anyone of these factors, if of sufficient
degree, can produce venous thrombosis but it is more
probable that the condition occurs only when all
factors are present in combination. There is statistical
evidence that postpartum thrombo- phlebitis occurs
more commonly following difficult labor, cesarean
section and instrumental delivery during which the
pelvic veins may suffer abnormal trauma which
provides a locus.
Nursing Intervention

Nursing Diagnosis
Ineffective Peripheral Tissue Perfusion
related to Decreased blood flow
evidenced by swelling of the affected
extremity redness/erythema and pain.

Planning
Improved perfusion will be
demonstrated by palpable and equal
peripheral pulses, good capillary refill,
reduced edema, and erythema.
The client will perform behaviors or
actions that will improve peripheral
tissue perfusion.
The client's tolerance for activity will
increase.
Nursing Intervention

Elevate the client’s feet and lower legs

above heart level when sitting or lying
down.
Encourage an increase in fluid intake of
2500 mL per day.
Apply warm, moist compresses or
heating pads to the affected extremity as
ordered.
Instruct the client to avoid tight clothing
and crossing her legs.
Instruct the client to prevent touching or
rubbing the affected extremity.
Apply support stockings as prescribed.
Caution is advised to prevent a
tourniquet effect.
Administer medication for postpartum
thrombophlebitis when the doctor
ordered.
Prepare client for surgical intervention
as indicated.
REFERENCES

https://www.physio-
pedia.com/Thrombophlebitis
https://www.mayoclinic.org/diseases-
conditions/thrombophlebitis/symptoms-
causes/syc-20354607
https://nurseslabs.com/postpartum-
thrombophlebitis-nursing-care-plans/?
fbclid=IwAR0VzEnfWnL9QFlN1amzvaoAfwu2KXI
_BVSQ2t11dyq5Jm4R1gwTHo_vjPo
https://www.sciencedirect.com/science/article/
abs/pii/S0025712516370171?fbclid=IwAR2ot-
2IyvNanZIfQoICknL9qAjdjciek3N33R0-lsaD-
g6wBtDb2d_IzhI