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8 Cards in this Set
- Front
- Back
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Signs and symptoms |
Pulses present Pitting edema (indicates about 10lbs of fluid, 2.2lbs=1L, so about 4L excess) Pain: aching, cramping (walking, elevation above heart may help). Skin changes: warm, tough, thickened, hyperpigmented (brownish discoloration from RBC rupturing). |
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PVD ulcer characteristics |
Moderately painful Pink or red base Irregular edges Heavy exudate/ drainage High rate of recurrence 3x more women than men Failure of valves > veins begin to PVDdistend |
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PVD ulcer treatment |
Compression (Unna boots) - inelastic gauze impregnated with zinc, glycerin, or calamine that becomes rigid when dry. Improves calf muscle pumping action/improves venous flow. Moist wound bed Pt must ambulate Composite wrap: multiple layers (1-skin protection/comfort, 2- high-stretch fiber provides gradient pressure, 3- short stretch fiber augments calf pump action), most compression at foot and lessens moving up the leg Compression hose don’t work for these pts Jobst stocking has much more compression than hose - custom fit. |
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VTE pathophysiology |
Venous stasis > venous clotting factors ^ > hypercoaguable blood injures vessel walls > platelet adhesions and increased clotting factors > thrombi form > thrombi break off and become emboli |
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VTE Prevention |
Mobility Anticoagulant Compression: stockings and SCDs |
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DVT signs and symptoms |
Homan sign positive in only 10% of pts. Pain Swelling - only sign for SCI pts Redness Heat |
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DVT Diagnosis |
Venous Compression Ultrasound - for uncertainty - a clotted vein won’t compress Doppler Ultrasound - for confirmation Computed tomography venography - used for pulmonary veins more than peripheral |
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DVT Tx |
Minimize mobility Surgery: remove thrombus, place IVC filter INR 2-3 or 2.5 to 3.5 for artificial valves Anticoagulant: Heparin (unfactionated) iv or SQ, or (low molecular weight) lovenox, SQ with PTT/INR Joint replacements bridge to coumadin. Coumadin - higher risk |
