CHAPTER 4 Hematologic System^199
- Record fluid intake and output to monitor renal function.
- Administer supplemental O 2 to increase available oxygen.
- Explain to the patient:
- Avoid the cold.
- No cold compresses.
- Plan for rest periods during the day.
Deep Vein Thrombosis (DVT)
WHAT WENT WRONG?
Thrombophlebitis, or the formation of a clot within the vein, commonly occurs
within the deep veins in the legs, and may also occur in the arms. Initially platelets
and white cells clump together, sticking to the inside of the vessel wall. As blood
flows over the area, other cells may deposit onto the area, making the thrombus
larger. Compression of blood flow, which will increase the venous pressure or
sluggishness of the blood flow, can increase the risk of clot formation. Im-
mobility, obesity, or hormonal changes such as pregnancy can all contribute to
increased risk.
PROGNOSIS
The clot may develop without any outward signs for some time. It may also be due
to another disease process or medication which affects clotting abilities. A small
piece of the clot may break free to become an embolus and travel elsewhere in the
body. This embolus may lodge in a vessel in the lung (a pulmonary embolism),
causing acute respiratory symptoms, possibly even death.
HALLMARK SIGNS AND SYMPTOMS
- Some patients will be asymptomatic
- Unilateral leg (or arm) pain or tenderness (calf, thigh, groin, upper or lower
arm) depending on location of thrombosis - Unilateral swelling of leg (or arm) due to vascular occlusion
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