Sandhya Jayathunga Nursing Tutor

1. THROMBOPHLEBITIS

3. Definition
• The inflammation of a vein
• Associated with clot formation in a deep or
superficial vein

4. Etiology and Pathophysiology
• An embolus is a clot or solid particle carried
by the bloodstream that may interfere with
circulation to vital organs

5. Risk Factors
• Venous stasis
• Immobilization
• Injury to venous endothelial lining
• Pregnancy
• Obesity
• Contraceptive therapy
• Hypercoagulability of the blood

6. Other Risk Factors
• Orthopaedic surgery
• Cancer of the - pancreas
- lungs
- genitourinary tract
• Trauma

7. Complications
• Pulmonary Emboli ( PE )
• Venous insufficiency

8. Clinical Manifestations
• Positive Horman’s signs(pain on dorsiflexion of affected extremity)
• Tenderness along course of the vein
• Increased tissue turgo
• Swollen limb with hard veins that are sensitive
to pressure

9. Clinical Manifestations
• Redness and warmth of area along the vein
• Distension of superficial veins
• May have a cyanotic appearance of the
extremity
• May have fever if infected

10. Diagnostic Evaluation
• Venography
• Doppler ultrasound

11. Management
• Bed rest with anti-embolytic stockings
• Warm moist heat application to promote
vasodilation if indicated
• Elevation of extremity to reduce oedema

12. Management
• Analgesics
• Thrombolytic therapy ( streptokinase)
• Anticoagulant therapy with warfarin (Coumadin)
• Surgical management - Thrombectomy

13. Nursing Assessment
• Calf circumference
• History of leg pain
• Presence of leg oedema
• Vital signs
• Increased temperature of affected leg

14. Nursing Interventions
1). Promote resolution of thrombus and
prevent further thrombus formation
a). Promote bed rest
b). Administer anticoagulant as ordered
c). Apply elastic hose as ordered
d). Elevate the affected extremity

15. Nursing Interventions
• Cont. 1).
e). Change position frequently
f). Maintain adequate fluid intake
g). Provide good skin care
h). Avoid wearing constricting garments
i). Instruct not to massage affected extremity

16. Nursing Interventions
2). Observe frequently for the signs of
vascular impairment
a). Pallor, cyanosis and coolness
b). Quality of pulse
c). Rapidity of capillary refill

17. Nursing Interventions
3). Apply anti- embolic stockings
• Remove and replace as ordered

18. Nursing Interventions
4). Observe for signs of pulmonary embolism
a). Sudden pain
b). Cyanosis
c). Haemoptysis
d). Shock

19. Nursing Interventions
5). Observe and record vital signs including
peripheral pulse
6). Take measures to alleviate anxiety

20. Nursing Interventions
7). Acute phase of thrombophlebitis care after
surgery
a). Monitor for haemorrhage
b). Assess circulatory status of the extremity
c). Keep extremity elevated

21. Nursing Interventions
Cont. 7).
d). Allow out of bed as ordered
e). Avoid prolonged hip flexion
f). Administer analgesics and anticoagulant as
ordered

22. Nursing Interventions
8). Give health education to the patient
a). Basic pathology of disease condition
b). Medication and side effects
c). Prescribed exercises
d). Correct use of elastic hose

23. Nursing Interventions
Cont. 8).
e). The importance of monitoring for signs of
bleeding
f). Need to stop smoking
g). Prevention of recurrent embolus formation

24. THANK YOU