SEMINAR

ON
THROMBOEMBOLIC
DISORDER

BY: MISS RASHMITA BORUAH

B.Sc. NURSING 4TH YEAR
ENROLLMENT NO. : ACAP280188
 INTRODUCTION
A Thromboembolism is a circulating blood clot that get struck and
causes an obstruction. It includes Deep Vein Thrombosis (DVT) and
pulmonary embolism (PE). Thromboembolism is one of the leading
causes for the maternal mortality during pregnancy.
 DEFINITION

A thromboembolism is a circulating blood clot that get

stuck and causes an obstruction.
(OR)

Thromboembolic Disorder is the formation of clots in

blood vessels that breaks loose and carried by the blood
stream to plug another vessels.
 INCIDENCE
 Thromboembolic disorders remains one of the main direct causes of
maternal death in UK and other developed countries.
 The risk of thromboembolism during pregnancy and the post pertum
period is 10 times greater than that for non-pregnant patients.
 Estimated attacks rates for DVT and PE are 91-255 and 51-75 per
100,000 person in year
 ETIOLOGY

 During pregnancy, a women’s blood clot more

easily to lessen blood loss during labour and
delivery.
 Pregnant women may also experience less blood
flow to the legs later in pregnancy because the
blood vessels around the pelvis are pressed upon
by the growing baby.
 CLASSIFICATION

DEEP VEIN
PULMONARY
THROMBOSIS
EMBOLISM(PE)
(DVT)
 DEEP VEIN THROMBOSIS

Deep vein thrombosis occurs

when a blood clot forms in one
or more of the deep veins in the
body, usually in the leg
 ETIOLOGY
A family or personal history of blood clots
or a blood clotting disorder.
Pregnant women may experience less blood
flow to the legs later in pregnancy because
the blood vessels around the pelvis are
pressed upon by the growing baby.
 CLINICAL FEATURES

 Pain in calf muscle.

 Edematous Legs.
 Rise in skin temperature.
 A positive homan’s sign
 INVESTIGATION

 History collection and physical examination.

 Doppler USG.
 Venous USG.
 MRI.
 Venography.
 MANAGEMENT

Medical Management
Pharmacological Management
 Analgesics
Morphine
Dose: 5-10 mg
Route: I V
 MECHANISM OF ACTION

Depress pain impulse transmission at the spinal cord level by

interacting with opioid receptors
SIDE EFFECTS
 CNS: Drowsiness, dizziness, confusion, headache, euphoria,
insomnia, seizures.
 CV: Bradycardia, shock, cardiac arrest, chest pain,
hypo/hypertension, tachycardia.
 EENT: Blurred vision, miosis, diplopia.
 GI: Nausea, vomiting.
 ANTICOAGULANTS
Heparin
Dose : 5000-10,000 units per ml.
Route: I V

Mechanism of action: Prevents conversion of fibrinogen to fibrin and prothrombin

to thrombin by enhancing inhibitory effects of antithrombin III

Side Effects:
CNS- Fever, chills, headache
HEMA: Hemorrhage, anemia
META: Hyperkalemia, Vitamin D deficiency.
Warfarin
Dose- 2.5-7.5 mg 1 day
Route- orally.

Mechanism of action: Interferes with blood clothing by indirect means, depresses hepatic synthesis of vit. K –
dependent coagulation factors
(II, VII,IX, X)

SIDE EFFECTS:
GI:- Nausea, Cramps
GU:- Hematuria
Non-Pharmacological Management:-
 Bed rest and foot and elevation.
 ElasticStocking: Compression stocking are specially designed to
apply pressure to your lower legs, helping to maintain blood flow
and reduce discomfort and swelling.
 It should wear during the day and take
them off before going to bed
 SURGICAL MANAGEMENT
 Thrombectomy:-

Thrombectomy is a type of surgery

to remove a blood clot from inside an artery or
vein.
Nursing Management:-
 Provide comfortable position by elevating the leg above the
level of the heart.
 Provide elastic compression stocking and guide them when
to use.
 Assess for edema, pain and temperature of the patient.
 Provide medication on time as per doctor prescription.
 Check the vital sign especially temperature .
 Clear the doubt of the patient and family member
 PULMONARY EMBOLISM

Pulmonary embolism is a conditions in which

one or more arteries in the lungs become blocked
by a blood clot.
Etiology:-
History of DVT
Heart Failure:- When you have blockages in the
arteries inside the lungs, the heart must work harder to
push blood through those vessels
Clinical Features:-
Dyspnea Cough
Tachycardia Pleuritic Chest Pain
Increased Temperature
Investigation:-
Historycollection and physical examination.
X-ray of chest.
ECG.
D-Dimer
Doppler ultrasound
Lung Scan
 MANAGEMENT
1. Medical Management:-
 Anticoagulant Therapy-
Heparin
Warfarin
 Analgesics
 Morphine

2. Surgical Management:-
 Embolectomy: Embolectomy is emergency surgical removal
of emboli which are blocking blood circulation.
NURSING MANAGEMENT

 Reduce the level of pain.

 Provide oxygen therapy as per order
 Monitor for any complication after surgery
 Administer medication on time as per order.
 Reducethe anxiety of the patient by providing
comfort and clarify the patient doubt.
Thank you