Question

Discussion Topic: What are the different treatment options and nursing instructions for superficial venous thrombosis versus acute pulmonary embolus?

Answer 1

Superficial venous thrombosis is the clotting formation in the superficial veins of arms and legs that is characterized by the skin over the vein becomes swollen, redness, and painful.

This condition usually subsides by self but for the symptomatic management, we can use NSAID or aspirin to relieve pain, Heparin to reduce blood clotting, heat, or warm application over the skin, compression stocking can be used for legs venous thrombosis, Excision and ligation can be done in case of sepsis or more infection of the part, puncture and evacuation can be done by inserting 18 gauge in the affected vein and evacuate the clot under local anesthesia.

The nursing interventions are

- Apply warm application on the affected part

- Advice to use compression stocking to the patient and explain to the patient how to use it.

- If the patient is under heparin therapy then watch for bleeding.

- Keep the pillows under the legs while sleeping and prevent prolong hanging of legs.

Acute pulmonary embolus is a condition where the lung's artery is blocked by the clot which is travel form the legs or other parts due to untreated deep vein thrombosis. This is a life-threatening condition that need immediate actions or intervention.

The treatment options include

- Respiratory support: oxygen administration, vasopressin administration as the patient is a risk for hypotension, mechanical ventilation, intubation can be used for serious patients.

- Hemodynamic support: In this also include IV fluid therapy, vasopressors, for hypotension. The fluid resuscitation and administration of vasopressors will help to improve the blood pressure.

- Empiric anticoagulant: This will helps to dissolve the clot in the blood snd prevent blockages of arteries in the lungs. But these drugs should be administered for low risk of bleeding patients.

Nursing intervention

- the nurse should assess the oxygen level fast and administered oxygen

- Check the blood pressure frequently

- Administered medication as per prescribed by a doctor

- Assess for the risk of bleeding before administering any anticoagulant.

- Provide CPR if needed.

- Administered IV fluid resuscitation to treat hypotension.

- Position the patient is fowlers position.