Sunday, January 15, 2006

thrombophlebitis (thrombosis, thromboembolism, blood clot)

Thrombophlebitis is an inflammation of veins that may result in clot formation. Thrombophlebitis has increased in the elderly population due to longer survival of critically ill people and more extensive surgical procedures. It is a well-established fact that a person's age has a profound influence on the susceptibility to thromboembolism.
Thromboembolism is an obstruction of a blood vessel by a blood clot that has broken loose from its site of formation. Thrombosis is the formation of blood clots inside a blood vessel or in one of the chambers of the heart. Many factors predispose a person to the development of a blood clot. These include inactivity, congestive heart failure, chronic illness, and prolonged bed rest.
There may be no subjective symptoms at first, but a vague ache may be noticed in the affected leg.
The classic symptoms of thrombophlebitis, however, include pain, tenderness, swelling, fever, increased heart rate, slight cyanosis (skin blueness), and slight prominence of veins in the affected area.
Treatment of thrombophlebitis includes rest, elevation of feet, local heat application, and administration of anticoagulants. Hospital admission is usually necessary for intravenous administration of anticoagulants and bed rest. Elastic support stockings may be helpful. Surgical intervention may be necessary if the thrombosis is extensive and recurrent or if embolization is recurrent. With danger of a pulmonary embolism, vena cava surgery may be useful.
Prevention of thrombosis is important. Early ambulation, elevation of the foot of the bed, and active and passive exercises of the legs in bed are effective. Elastic support of the legs also is of value.
The most feared complication of deep thrombophlebitis is pulmonary embolism, which can cause sudden death.
Scherer, J. C. Introductory Medical-Surgical Nursing, 3rd ed. Philadelphia: J. B. Lippincott Co., 1982.
Steinberg, F. U. Care of the Geriatric Patient, 6th ed. St. Louis: C. V. Mosby Co., 1983.

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