(^200) Medical-Surgical Nursing Demystified
- Positive Homan’s sign (pain on dorsiflexion of foot) seen in minority of
patients with DVT - Warmth over the site
INTERPRETING TEST RESULTS
- Doppler flow studies.
- Venous duplex ultrasound.
- Impedence plethysmography looks at venous outflow; better at diagnosis in
thigh than in calf. - Venography uses contrast dye to visualize the thrombus; not commonly done
due to need for dye and other available tests. - MRI direct thrombus imaging useful for inferior vena cava and pelvic vein
locations. - PT, PTT, INR, and CBC with platelet count as baseline.
- D-dimer to test for hypercoagulable state.
TREATMENT
Most patients undergo medical management and rest. Preventive measures are
instituted for future occurrences. Patients with repeat occurrences may have an
umbrella filter implanted.- Bedrest with elevation of extremity.
- Warm, moist soaks of the area.
- Monitor prothrombin time (PT), partial thromboplastin time (PTT), interna-
tional normalized ratio (INR). - Weight-dosed heparin IV.
- Low molecular weight heparin.
- Warfarin.
- Thrombolytic therapy to dissolve clot with drugs such as recombinant tissue
plasminogen activator (t-PA). - Umbrella filter is inserted into the inferior vena cava for patients with recur-
ring DVT. - Thrombectomy is the surgical removal of the thrombus.