THROMBOPHEBLITIS Thrombopheblitis is an inflammation of the vein walls it usually occurs in an extremity, especially one of the legs, inflammation due to response to a blood clot in the vessel.

1. THROMBOPHEBLITIS
Thrombopheblitis is an inflammation of the vein walls it usually occurs in an
extremity, especially one of the legs, inflammation due to response to a blood
clot in the vessel.
ETIOLOGY/pathophysiology

2. Thrombopheblitis
 Superficial Thrombophlebitis Thrombophlebitis is the inflammation of a
vein (usually in an extremity, especially one of the legs) that occurs in
response to a blood clot in the vessel. When it occurs in a vein near the
surface of the skin, it is known as superficial thrombophlebitis, a minor
disorder commonly identified by a red, tender vein.
 Deep-vein thrombophlebitis (affecting the larger veins farther below the
skin’s surface) is more serious. It may produce less-pronounced symptoms
at first (half of all cases are asymptomatic) but carries the risks of pulmonary
embolism (when the clot detaches from its place of origin and travels to the
lung) and chronic venous insufficiency (impaired outflow of blood through the
veins), resulting in dermatitis, increased skin pigmentation and swelling.
Causes
 Stagnation of blood flow due to immobility. This is common among bedridden
patients (such as heart patients and those who have undergone any type of
major or orthopedic surgery, especially of the hip or knee) and healthy
persons who sit or lie still for an extended period --for example, on a long
trip.
 Blood vessel injury, caused by trauma, intravenous catheters or needles,
chemotherapeutic agents, or infectious organisms.
 Conditions that increase the tendency for blood to coagulate, such as a
familial deficiency in anti-clotting factors or disorders like systemic lupus
erythematosus.
 Pregnancy and varicose veins are associated with a higher risk of superficial
thrombophlebitis.
 Deep-vein thrombophlebitis is associated with a number of different cancers.
CLINICAL MANEFESTATION
DVT's signs and symptoms are nonspecific.

3. except PHLEGMASIA CERULEA DOLENS (massive iliofemoral venous
thrombosis), in which the entire extremity becomes
*massively swollen
*tense
*painful
*coll to touch
DEEP VEINS
with obstruction of the deep veins comes edema and sweeling of the extremity
because the outflow of venous blood is inhibited. The amount of swelling can be
determined by measuring the circumference of the affected extremity at various
levels with the tape measure and comparing one extremity with the other at the
same level to determine size differences.
If both extremities are swollen, a size difference may be difficult to detect. The
affected extremity may feel warmer than the unaffected extremity, and the
superficial veins may appear more prominent.
Tenderness, which usually occurs later, is produced by inflammation of the vein
wall and can be detected by gently palpating the affected extremity.
Homan's sign (pain in the calf after the foot is sharply dorsiflexed) is not specific
for DVT because it can be elicitd in any painful condition of the calf. In some
cases, signs and symptoms of a pulmonary embolus are the first indication of
DVT.
SUPERFICIAL VEINS
Thrombosis of superficial veins produces pain and tenderness, redness, and
warmth in th einvolved area. The risk of the superficial venous thrombi becoming
dislodged or fragmenting into emboli is very low because most of them dissolve
spontaneously.
This condition can be treated at home with bed rest, elevation of the leg,
analgesic, and possibly anti-inflammatory.

4. ASSESSMENT AND DIAGNOSTIC FINDINGS
PREVENTION
venous thrombosis, THROMBOPHEBLITIS, and DVT can be prevented,
especially if the patient who considered at high risk are identified and preventive
measures are without delay.
Preventive measures include the :
application of elastic compression stockings
use of intermittent pneumatic compression devices
special body positioning and exercise.
and additional method to prevent venous thrombosis in surgical patients is
administration of subcutaneous unfractioned or low-molecular-weight
heparin (LMWH).
MEDICAL MANAGMENT
PHARMACOLOGIC THERAPY
Measures for preventing or reducing blood clotting within the vascular system
are indicated in the patients with thrombopheblitis, recurrent embolus formation,
and persistent leg edema from heart failure. They are also indicated in elderly
patients with hip fractire that may result in lenghty immobilization.
* UNFRACTINATED HEPARIN
* LOW-MOLECULAR HEPARIN
* THROMBOLYTIC THERAPY
* FACTOR XA INHIBITOR
* ORAL ANTICOAGULANTS
SURGICAL MANAGEMENT
Surgery is necessary for DVT when anticoagulant or thrombolytic therapy is
contraindicated, the danger of pulmonary embolism is extreme, or venous

5. drainage is so severely compromised that permanent damage to the extremity is
likely.
A thrombectomy (removal of thrombosis) is the procedure of choice. A vena cava
filter may be placed at the time of the thrombectomy; this filter traps large emboli
and prevents pulmonary emboli. Balloon angioplasty and stent placement are
being used in the illiac veins of the patients with acute and chronic venous
disease..
NURSING MANAGEMENT
*ASSESSING AND MONITORING ANTICOAGULANT THERAPY
*MONITORING AND MANAGING POTENTIAL COMPLICATIONS
>bleeding
>thrombocytopenia
>drug interactions
*PROVIDING COMFORT
*COMPRESSION THEORY
>stockings
>wraps
*POSITIONING THE BODY AND ENCOURAGING EXERCISE
*PROMOTING HOME AND COMMUNITY-BASED CARE