Deep Vein Thrombosis Patient Care Plan

This assignment outlines a comprehensive care plan for a patient diagnosed with Deep Vein Thrombosis (DVT). It emphasizes the importance of nursing interventions such as compression stockings, regular ambulation, positioning techniques, range-of-motion exercises, and vigilant monitoring of vital signs. The plan also highlights effective communication strategies and adherence to evidence-based practices for DVT management.

Running head: DEEP VEIN THROMBOSIS
DEEP VEIN THROMBOSIS
Name of the Student
Name of the University
Author note

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My clinical placement was on CONCORD HOSPITAL Sydney in oncology ward. I
was looking after a patient named Mr X is who is suffering from deep vein thrombosis; he is
65 years of age. He is having a complain of swelling in the left leg for 30days. He was having
a right sided abdominal pain for last 20 days and having breathlessness for 4 days. He takes
mixed diet and is a chain smoker. The weight of the patient is 88 kg and he was not suffering
from any cough, altered sensorium, trauma or improper bowel habits. Two years before he
was diagnosed with arthritis which he takes NSAIDS and he is non-diabetic however, he
suffers from hypertension. He is asthmatic and not a tuberculosis or epileptic patient. He is
suffering from breathlessness for last 3 days and the abdominal pain which is dull aching
towards the right hypochondria as well as no relieving or non-aggravating. He was suffering
from fever, weakness, nose bleeding and swollen nodes. One year before Mx.X was
diagnosed with leukaemia.
Deep vein thrombosis (DVT) is an illness which occurs when there is a blood clot in
the vein that is present deep inside the body. A blood clot is cluster of blood which is turned
in solid state (Watson et al. 2016). DVT clots forms in thigh or else in lower leg, however
they develop in other regions of the body. The blood clots for DVT is caused as it prevents
the blood from circulating or clotting generally, like injury in a vein, during surgery, or due to
specific medications besides restricted movement.
DVT is highly serious as blood clots in veins breaks the loose, that travel through the
bloodstream besides stays in the lungs, thereby blocking the flow of blood (pulmonary
embolism). The symptoms of DVT includes pain in leg due to swelling, discoloured or red
coloured leg or feeling of warmth in the affected leg. DVT can also occur deprived of
perceptible symptoms (Di Nisio et al. 2016). Prophylaxis helps in treating DVT.

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The pathophysiology of DVT- It is caused due to pulmonary embolism and due to
impairment in the venous return, dysfunction, hypercoagulability as well as endothelial
injury. Valves coordinates blood flow by venous circulation and DVT creates potential
location for the hypoxia and venous stasis (Othieno et al. 2018).
The risk factors for DVT includes family history of blood clotting disorder, surgery or
injury, long bed rest or paralysis, cancer, overweight, heart failure, smoking or inflammatory
bowel movement. DVT have precise risk factors which have been extensively deliberate to
progress diagnostic methods in addition to, more prominently, anticipation. The most mutual
origins are in boundaries, where lower extremity is superior in comparison to the upper
extremity, which can occur in mesentery or else pelvic veins (Streiff et al. 2016). These are
not noticeable by Doppler ultrasound investigation. The prophylaxis grounded on the risk
factors is experienced in every hospital, with use of Lovenox along with pneumatic pressure
devices or other anticoagulants. In this case the patient was found to be overweight as well as
smoker. Hence, both of these factors creates pressure on veins thereby reducing blood flow
and causing DVT. The most significant cause for DVT in Mr. X is leukaemia. Cancer cell
damages the tissues causing swelling and instigating clotting. They churn out chemicals
causing clots.
The care was being implemented of Mr. X was first to provide him comfort. The
nurses must make sure that the left leg is in comfortable situation, so that there is proper
blood flow. In case of Mr. X it is predicted that leukaemia is increasing the pain. After
keeping his leg in comfortable position a Doppler ultra sound treatment would be given to
him as this sound waves can identify the blood flow in the veins and blood clots can be
noticed (Ageno et al.2016). The x-ray image would also give a clear analysis blood clots. All
the test arrangement would be done by nurses. Mr. X would be taken to the X-ray unit of
oncology for analysis. I recommended that the reduced mobility is defined as a strong risk

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factor for deep vein thrombosis besides they should be considered in context of oncology. In
my nursing knowledge I have noticed that palliative patient undergoes DVT risk assessment
and patient who are in terminal stage do not require prophylaxis (Meissner 2019). However,
Mr. X needs prophylaxis for treatment. The patient care approach is fulfilled by discussing
the risk factors with the patient. I as a nurse made the patient relax and comfortable and even
ask the patient if he is comfortable enough to discuss his health issue at that moment if not I
would ask him when to come and explain him the disease. Then I shared details about VTE
(venous thromboembolism), I will share about the signs and symptoms of VTE and would
link it with leukaemia that he is already undergoing. I explained him all the risk factors for
VTE that his blood clot might lead to pulmonary or heart failure and I will also explain him
that due to leukaemia the cell damages are occurring causing inflammation and blood clots
(Friedman et al. 2018).
Involvement of the multidisciplinary team would help and better collaboration of
health professionals and practitioners in the field of health and social care to collaborate
effectively. An effective caring would help in greater satisfaction from the patient side and
efficient resources are used for enhancing the treatment measures for Mr. X. I checked if Mr.
X needs any pharmacological as well as mechanical prophylaxis required during admittance
of patient that commenced for risk assessments and care (Health.nsw.gov.au, 2020). The
pattern of mechanical and pharmacological prophylaxis need to be informed as evidence.
PHOs would be ensured about the system which are in place in order to provide clinicians to
have an access to all the evidence guidelines and protocols. Health High Risk Medicines
Management Policy Directive guidelines are to be followed for proper pharmacological
prophylaxis setting in the pattern of an anti-coagulant and that needs accordance.
DVT prevention is needed hence, the documentation for Prophylaxis would be done
by electronic prescribing system that were in use. The medical officer who is attending Mr. X

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would be in charge of this can confirm the use of prophylaxis for DVT prevention. I as a
nurse prescribe mechanical or pharmacological prophylaxis according to the protocol.
However, I should keep in mind that any prescription outside the section would be considered
as a duplication of order causing harm to patient (Safetyandquality.gov, 2020). The
mechanical prophylaxis with check associates are documented twice by the nurses and
midwives. We used mechanical prophylaxis to prevent DVT and we have received significant
result. It compresses and makes the blood flow normal however, mechanical prophylaxis
causes nausea, vomiting, tiredness and diarrhoea in patient. This further sickness scares
patient from taking the treatment.
On other hand, I noticed that there was lack in communication regarding use of PHO
VTE prevention in the hospital. There was no proper strategy to proctor VTE incidents which
would determine the mortality and mobility of the hospital. Hence, a proper effective
communication and planning required for this (Nursingmidwiferyboard.gov.au, 2020).
It can be concluded by explaining that DVT patient needs proper care. DVT patient
must know in detail about their disease and they must flow some measure such as
compressed stocking and take walks every day. The patient must follow these so that there is
blood flow. I personally would follow an effective means of communication, I would see that
the legs are in proper comfortable position and even after very two hours I will turn the
patient without crossing the legs, I would make sure that the patient is doing range of motion
exercise every day and most important I will always monitor the vital signs for the DVT
patient.

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References
Ageno, W., Mantovani, L.G., Haas, S., Kreutz, R., Monje, D., Schneider, J., Van Eickels, M.,
Gebel, M., Zell, E. and Turpie, A.G., 2016. Safety and effectiveness of oral rivaroxaban
versus standard anticoagulation for the treatment of symptomatic deep-vein thrombosis
(XALIA): an international, prospective, non-interventional study. The Lancet Haematology,
3(1), pp.e12-e21.
Di Nisio, M., van Es, N. and Büller, H.R., 2016. Deep vein thrombosis and pulmonary
embolism. The Lancet, 388(10063), pp.3060-3073.
Friedman, R.J., Gallus, A.S., Cushner, F.D., Fitzgerald, G., Anderson Jr, F.A. and Global
Orthopaedic Registry Investigators, 2018. Physician compliance with guidelines for deep-
vein thrombosis prevention in total hip and knee arthroplasty. Current medical research and
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Health.nsw.gov.au. 2020. Clinical Guidelines for Nursing and Midwifery Practice -
Professionals. Retrieved 26 May 2020, from
https://www.health.nsw.gov.au/aod/professionals/Pages/clinical-guidelines-nursing-and-
midwifery.aspx
Meissner, M.H., 2019. Thrombolytic therapy for acute deep vein thrombosis and the venous
registry. Reviews in cardiovascular medicine, 3(S2), pp.53-60.
Nursingmidwiferyboard.gov.au, 2020. Nursing And Midwifery Board Of Australia -
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<https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-
standards.aspx> [Accessed 26 May 2020].

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Othieno, R., Okpo, E. and Forster, R., 2018. Home versus in‐patient treatment for deep vein
thrombosis. Cochrane Database of Systematic Reviews, (1).
Safetyandquality.gov. 2020. The NSQHS Standards | Australian Commission on Safety and
Quality in Health Care. Retrieved 26 May 2020, from
https://www.safetyandquality.gov.au/standards/nsqhs-standards
Streiff, M.B., Agnelli, G., Connors, J.M., Crowther, M., Eichinger, S., Lopes, R., McBane,
R.D., Moll, S. and Ansell, J., 2016. Guidance for the treatment of deep vein thrombosis and
pulmonary embolism. Journal of thrombosis and thrombolysis, 41(1), pp.32-67.
Watson, L., Broderick, C. and Armon, M.P., 2016. Thrombolysis for acute deep vein
thrombosis. Cochrane Database of Systematic Reviews, (11).