Deep Vein Thrombosis (DVT)

Definition

Deep Vein Thrombosis (DVT) is the formation of a blood clot in a deep vein, most commonly in the leg. DVT is a critical risk factor for pulmonary embolism (PE), which can be fatal.

Virchow's Triad (Risk Factors)

• Stasis: Immobility, bed rest, long flights, recent surgery.
• Endothelial injury: Trauma, central lines, surgery.
• Hypercoagulability: Cancer, pregnancy, oral contraceptives, inherited thrombophilias (Factor V Leiden).

Signs and Symptoms

Unilateral leg swelling, warmth, erythema, tenderness, and possibly palpable cord. Homan's sign (calf pain on dorsiflexion) is unreliable and no longer recommended.

Nursing Interventions

Do NOT massage the affected leg. Risk of dislodging the clot! Initiate anticoagulation (heparin, LMWH, warfarin, DOAC) per protocol. Elevate the extremity. Apply graduated compression stockings or sequential compression devices (SCDs) as prophylaxis in other patients. Teach signs of PE: sudden dyspnea, chest pain, hemoptysis, tachycardia (medical emergency).

NCLEX Relevance

DO NOT MASSAGE is a critical safety rule. Recognize PE as a life-threatening complication.