Abdullah Mohsin: Possible Nursing Interventions for a Patient with DVT
Abdullah Mohsin, B. Tech Software Engineering Student and Active Researcher, shared a post on LinkedIn:
“Nursing Interventions
Nursing interventions and care are essential for the patients recovery.
In the following section, you will learn more about possible nursing interventions for a patient with deep vein thrombosis.
1.Start anticoagulation.
The cornerstone of DVT treatment is anticoagulation.
DVT treatment has three primary goals:
- Stop the clot from getting bigger.
- Stop the clot from dislodging and moving onto the lungs.
- Lessen the likelihood of another DVT.
2. Administer medications cautiously as ordered.
Anticoagulants and clot busters (thrombolytics) can increase the risk of bleeding. Monitor the coagulation profile (PT/INR, aPTT) and implement the following bleeding precautions:
- Use a soft bristle toothbrush
- Avoid invasive procedures if possible
- Avoid forceful sneezing or blowing the nose
- Prevent falls and injuries
- Shave with electric razors
- Apply pressure when removing IV lines
3. Monitor aPTT with unfractionated heparin (UFH).
- The patient receiving inpatient treatment for DVT may receive IV UFH.
- The nurse monitors the aPTT every 6 hours and adjusts the infusion rate per facility guidelines.
4. Administer low molecular weight heparin (LMWH).
- Common LMWH options include enoxaparin, apixaban, and rivaroxaban, and are used to prevent the formation of new blood clots.
5. Monitor for therapeutic international normalized ratio (INR) levels.
- If the patient is prescribed warfarin to continue outpatient, the medication is overlapped with another anticoagulant until the international normalized ratio (INR) reaches the therapeutic range of 2-3.
6. Consider a vena cava filter.
The inferior vena cava (IVC) filter stops large emboli from reaching the lungs. Although an IVC filter can lessen the risk of pulmonary embolism, it cannot stop additional blood clots from developing.
An IVC filter is inserted in patients who:
- Cannot take blood-thinning drugs
- Experience recurrent blood clots despite anticoagulation
7. Apply compression stockings.
- Compression stockings and intermittent pneumatic compression devices prevent blood from pooling in the legs and reduce edema, which reduces the risk of recurrent DVT and postthrombotic syndrome.
8. Advise the patient to ambulate and change positions frequently.
- Staying in one position for a long time increases DVT risk, such as through prolonged sitting (such as driving), prescribed bed rest, or paralysis.
- Bed rest for fear of dislodging a clot in the extremities is unfounded and not recommended.
- If the patient is limited in movement, they should be instructed to move their legs as applicable by flexing the feet, rotating the ankles, and lifting the knees.”
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