DVT or VTE? | What's that triad? | Prevention | Rudolf the German Doctor | 1, 2, 3, anticoagulate ! |
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What is a DVT?
This clot forms in a vein and remains in situ
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What is hypercoagulability?
Thrombophilia, pregnancy, high estrogen levels
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What are mechanical and pharmacological?
The 2 basic types of preventive interventions. One can be applied to the lower extremities, the other, administered PO, SQ or IV.
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Who is Rudolf Virchow?
150 Years ago, this German cellular biologist and MD identified 3 phenomenon which contributed to DVT.
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What are types of PO anticoagulants?
Warfarin, Xarelto, Eliquis
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What is a DVT?
Deep Vein Thrombosis
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What is venous stasis?
Immobility, obesity, CHF, stroke
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What is mobility?.
This intervention can improve muscle strength and increase circulation. Forms include ambulation, passive range of motion, or even just sitting your patient in a chair!
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What is endothelial damage?
Irritation of the vessel and its surroundings
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What is INR
This needs monitoring for patients on warfarin. Normal is 1.0
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What is a VTE?
This forms in a vein and travels throughout the body
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What is endothelial damage?
Surgery, Central line, Hyperinflammatory /hyperimmune response
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What are compression stockings?
This leg wear that prevents venous stasis should be worn for 18 hours daily. Use caution with diabetes and peripheral neuropathy!
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What is hypercoagulability?
Increased ability of the blood to clot
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What is SQ?
Lovenox and Arixtra are administered by this route. Sometimes heparin too.
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What is a VTE?
When these reach the lungs, they cause PEs, the 3rd most common cause of death in hospitalized patients.
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What is venous stasis?
Age over 40, varicose veins
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What is skin integrity?
When using SCDs, it is important to monitor this Q 8 hours. Document your finding!!
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What are the 3 components of Virchow's triad?
Venous stasis, endothelial damage, hypercoagulability
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What is daily?
Evaluation for adequacy of DVT prophylaxis should be done this often
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What is a VTE?
1/3 of these are fatal
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What is hypercoagulability?
Smoking, cancer, sepsis
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What is documentation??
This must be done consistently after prophylactic interventions are implemented. Or if a patient refuses treatment
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What is venous stasis?
Interruption or slowing of blood flow
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What are contraindications for pharmacologic anticoagulants?
Recent cardiovascular hemorrhage, Impending surgery of brain or spinal cord, Severe liver disease/heavy ETOH use, Severe trauma, Recent major surgery
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