POSTPARTUM THROMBOPHLEBITIS bsc nursing.pptx

Nursing

1. POSTPARTUM THROMBOPHLEBITIS

2. Definition Thrombophlebitis is the inflammation of a vein with blood clot formation inside the vein at the site of inflammation. Thrompophlebitis is also known as phlebitis, phlebothrombosis , and venous thrombosis.

3. Superficial thrompophlebitis When thrompophlebitis occurs in a superficial vein, one that is near the surface of the skin and is visible to the eye, the disease is called superficial thrompophlebitis

4. Causes Pre- eclampsia Obesity, age >35 & parity >4 Past or family history Injury to blood veins Increased blood clotting Blood stasis Malignant tumors Genetic disorders Oral contraceptives As a consequence of varicose veins Prolonged bed rest

5. Factors that increases the risk of Thrombosis: Inactivity Cesarean birth Smoking History of previous thrombosis Varicose veins Diabetes Mellitus Prolonged time in stirrups

6. Symptoms Usually develops in the 2 nd week of postpartum The main symptoms are tenderness and pain in the area of the affected vein. Redness and / or swelling The patient may experience muscle stiffness in the affected area. Mild fever prior to local manifestations and at times fever and chills Polymorphonuclear leukocytosis seen on blood count

7. Diagnosis usually be detected by a physician using palpation (touching or massage). Deep venous thrombosis requires specialized diagnostic procedures to detect the blood clot Homan’s sign: dorsiflexion of the foot may demonstrate an increase in calf or thigh pain Blood samples should be taken for full screening including prothrombin time Doppler ultrasound to detect the changes in the velocity of bood Phlebography to note the filling defect in the vein lumen Isotopic venography to detect radioactivity

8. Treatment Superficial thrombophlebitis usually resolves without treatment. If treatment of superficial thrombophlebitis is given, it usually is limited to the application of heat or anti-inflammatory drugs, like aspirin or ibuprofen, which also help to relieve the pain. It can take from several days to several weeks for the clot to resolve and the symptoms to completely disappear Keeping the affected limb elevated

9. Management Leg movement and exercises Elastic stockings Active breathing exercises Avoid sitting with leg dangling down Intermittent calf muscle compression: passive dorsiflexion Prophylactic anticoagulant therapy Avoiding the use of estrogen for suppression of lactation

10. Management measures for the client with DVT include: Bed rest with the foot end raised above the heart level Analgesics to relieve pain in the affected area & sedatives to ensure sleep Antibiotics Heparin therapy: 15,000 units IV, Continued for 7-10 days or even longer. Warfarin orally is commonly used in addition to heparin and may be continued for 3-6 months as maintenance therapy. Gentle movement in bed to be started when the pain subsides Caval filter may be inserted if there is a free-floating thrombus detecting by scan or phlebogram .