For students

1. NMT06207: Care of Patients
with Medical Conditions
Session 7: Care of A Patient with
Phlebitis
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2. Learning tasks
At the end of this session, students are
expected to be able to:
• Define phlebitis
• Identify risk factors of phlebitis
• Identify signs and symptoms of phlebitis
• Identify diagnostic measure of phlebitis
• Give care to a patient with phlebitis
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3. Activity: Brainstorming
• What is Phlebitis?
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4. Definition
• Phlebitis is defined as an inflammation of a
vein related to a chemical or mechanical
irritation, or both.
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5. Activity: Brainstorming
• What are the risk factors of Congestive
Phlebitis?
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6. Risk Factors of Phlebitis
• The risk of phlebitis increases with the
length of time the IV line is in place
• The composition of the fluid or medication
infused (especially its pH and tonicity),
• The size and site of the cannula inserted,
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7. Risk Factors of Phlebitis..
• Ineffective filtration, improper securing of
the line and the introduction of
microorganisms at the time of insertion
• Prolonged inactivity-staying in bed or
sitting for many hours, creating stagnant or
slow flow of blood from the legs in a
dependent position This pooling of blood
in the legs leads to thrombus formation.
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8. Risk Factors of Phlebitis..
• Sedentary lifestyle
• Certain medical conditions that increase
the clotting potential of the blood
• Injury to your arms or legs
• Hormone replacement therapy or birth
control pills
• Pregnancy
• Varicose veins
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9. Signs and Symptoms of
Phlebitis
• The inflamed area is characterized by a
redness
• Warm area around the insertion site or
along the path of the vein
• Pain or tenderness at the site or along the
vein
• Swelling
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10. Diagnostic Measures of Phlebitis
• D-dimer is a blood test that measures a
substance that is released as a blood clot
dissolve.
• Ultrasound can detect clots or blockage of
blood flow, especially in larger, more
proximal (upper leg) veins.
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11. Diagnostic Measures of
Phlebitis..
.
• Occasionally a venogram is needed to
identify blood clots in the smaller, more
distal veins.
o This is an invasive procedure that requires
injecting X-ray dye or contrast material into a
vein on the foot, and then an X-ray is taken of
the flow of the dye up the leg
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12. Care of a Patient with
Phlebitis
• Applying a warm, moist compress to the
affected site.
• Observing the site hourly for any
complications
• Anchor the cannula or needle well,
• Change the IV site according to health
facility policy and procedures
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13. Care of a Patient with
Phlebitis..
• Encourage patient to increase walking to
increase blood flow
• This helps prevent blood clots from
developing
• Apply leg compression
stockings (knee or thigh high) improve
blood flow and may help to relieve pain
and swelling
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14. Care of a Patient with
Phlebitis..
• Discourage prolonged bed rest periods
to the patient
• Hospitalize the patient for few days to
ensure that no complications occur
• Discourage IV canular to stay in situ for
long period
o Discontinue IV and restarting it in another
site
• Give ant pain and ant-inflammatory
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15. Care of a Patient with
Phlebitis..
• Promote prevention of phlebitis in caring
patient
o Use aseptic technique during insertion of IV
cannular
o Use appropriate-size cannula or needle for
the vein, considering the composition of
fluids and medications when selecting a site
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16. Key Points
• Phlebitis is an inflammation of a vein related
to a chemical or mechanical irritation, or both.
• Clinical features that can be noted include
reddened warm area around the insertion site
or along the path of the vein.
• Pain or tenderness at the site or along the
vein and swelling
.
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17. References
• Alexander, M. F., Fawcett, J. N. & Runciman, P. J.
(2002). Nursing Practice: (2nded). London,
Churchill Livingstone.
• Bewes, P. (2003). Surgery. A manual for rural
health workers. (2nded.). Nairobi. AMREF.
• Dixon, E et al. (1983). Theatre Technique.
(5thed.). London: Bailliere Tindel.
• Monahan F.D and Sands J.K (2007). Medical
surgical nursing health and illness perspective
(8thed.). Canada: Mosby Elsevier
•
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18. References
• Alexander, M. F., Fawcett, J. N. & Runciman,
P. J. (2002). Nursing Practice: (2nded).
London, Churchill Livingstone.
• Bewes, P. (2003). Surgery. A manual for rural
health workers. (2nded.). Nairobi. AMREF.
• Black, J. M.& Hawks, J.H. (2009). Medical
surgical Nursing. (8thed.). Philadelphia: W.B
Saunders Company
• Brunner and Suddath. S. (2010). Medical
Surgical Nursing (12th ed.), New York,
Lippincott
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19. Review questions
• What are the causes of phlebitis?
• How can you diagnose the patient with
phlebitis?
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