Venous disorders

Prepared by:-
Mrs.Sumathigopinath
Lecturer
ACN
Venous disorders
Types:-
Acute-thrombo embolism
Chronic – varicose vein formation, chronic venous
insufficiency.
Acute venous disorders
thrombophlebitis
Causes :-
 Thrombus

Blockage in superficial /deep veins.

Venous stasis- due to immobilization
Hypercoagulability
Injury to the venous wall.
Heart disease-MI,cardiomyopathy
Orthopedic surgery
Age>40 yrs
Pregnancy
Obesity
H/o clotting disorders.
Post operative edema.
Pathophysiology
Venous return is aided by calf muscle pump
If it gets inactive
Blood pools in the veins
Platelet adherence to the endothelium( thrombin,fibrin
catacholamines are activated)
ADP is released from the damaged tissues.
ADP produces platelet aggregation
Thrombi
when thrombi becomes bigger it obstructs the veins.
venous insufficiency
Clinical features
Superficial thrombophlebitis:-
 Redness
 Warmth
 Tenderness
 Discomfort
Deep:-
 Unilateral leg swelling
 Pain
 Lowgrade fever
 Homan’s sign-discomfort in the upper calf during
dorsiflexion of the foot
Diagnostic evaluations
 Venous duplex scanning-to find out DVT
 Venography- contrast medium
 D-dimer blood test-product of fibrin degradation and
it is an indicative of fibrinolysis.
 Duplex imaging
 Plethysmographic examination.
Management
 Reduce risk of DVT
 Prevent emboli/thrombus formation
Superficial:-
warm packs
Elevation of the extremity
Early ambulation
Anti inflammatory drugs can be given
Anticoagulant therapy- prevent thrombi
Surgical management
 Thrombectomy
 Reducing pulmonary embolism-inserting a filter into
the vena cava to filter the blood before it reaches the
lungs.
Nursing management
1.Prevent existing thrombi
2.Closely monitor the effect of anticoagulant
medications.
3.Prevent DVT-moving of legs.
 Using of sequential compression devices
 Advice to take bed rest.
 SCD’s are removed twice daily .
4. Prevent venous return
Elevation of the leg above the heart level.
Elevate the foot end of the bed 6 inches.
Apply elastic wraps from toe to groin.
5.Reduce discomfort
6.Monitor anticoagulant therapy
7.Monitor for pulmonary embolism.