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What are the three criteria in Virchow’s Triad?
Venous stasis – slow blood flow (immobility, surgery, heart failure)
Endothelial injury – vessel wall damage (trauma, IV lines)
Hypercoagulability – increased clotting tendency (cancer, pregnancy, estrogen, dehydration)
How does Virchow’s Triad relate to the pathophysiology of thrombus formation?
Each factor contributes to clot development: sluggish flow, vessel injury, or thickened blood leads to platelet aggregation → fibrin formation → thrombus (clot) development → potential embolization.
What are the clinical manifestations of a DVT?
Unilateral leg swelling or edema
Pain or tenderness (often in calf)
Warmth and redness over affected area
Dilated superficial veins
Positive Homans’ sign (pain on dorsiflexion — no longer used diagnostically)
What are the nursing assessments for someone with suspected DVT?
Compare limb size and color bilaterally
Assess for warmth, tenderness, and edema
Check peripheral pulses
Monitor vital signs (watch for PE symptoms)
What pharmacological interventions are used to treat DVT?
Anticoagulants: Heparin (acute), warfarin or DOACs (long-term)
Thrombolytics: Used in severe or life-threatening cases
Pain management: Analgesics as needed
What non-pharmacological interventions are used for DVT?
Bed rest initially (to prevent embolization)
Elevate limb (to reduce swelling)
Compression stockings after acute phase
Hydration to reduce blood viscosity
Early ambulation post-prevention phase
Why is a pulmonary embolus (PE) considered life-threatening?
The clot blocks blood flow in pulmonary arteries → impaired gas exchange → right heart strain → decreased oxygenation → possible cardiac arrest.
Who is at risk for developing a PE?
Post-surgical or immobile patients
Those with DVT or history of clots
Pregnant or postpartum clients
Cancer patients
Those taking estrogen therapy
Smokers and those with obesity
How can we prevent pulmonary embolus
Early ambulation post-op
Sequential compression devices (SCDs)
Leg elevation
Hydration
Prophylactic anticoagulants (e.g., heparin, enoxaparin)
What is the classic triad of symptoms for pulmonary embolus (PE)?
Dyspnea (sudden shortness of breath)
Chest pain (pleuritic, sharp)
Hemoptysis (coughing up blood)
Other signs: tachycardia, anxiety, low O₂ saturation, hypotension.
What are nursing priorities for a suspected PE?
Elevate head of bed
Apply O₂ immediately
Stay with patient; reduce anxiety
Notify physician/RRT
Prepare for possible anticoagulant or thrombolytic therapy
Monitor vitals and SpO₂ continuously
How are DVT and PE diagnosed?
DVT: Doppler ultrasound, D-dimer test
PE: CT pulmonary angiography, V/Q scan, ABGs (show low PaO₂)