Thrombosis is when a blood clot, or thrombus, forms in a blood vessel and when a clot, fat, air bubble,

or other feature travels through blood vessels, with a risk of lodging elsewhere. Both can block blood
flow and increase the risk of a heart attack or stroke and it is a medical condition that occurs when a
blood clot forms in a deep vein. These clots usually develop in the lower leg, thigh, or pelvis, but they
can also occur in the arm.

It is important to know about DVT because it can happen to anybody and can cause serious illness,
disability, and in some cases, death. The good news is that DVT is preventable and treatable if
discovered early.

Causes of Deep Vein Thrombosis

-Blood clots may form when blood flow in your veins slows down or becomes blocked

. -DVT becomes more likely if you have one or more of these risk factors: Being sedentary due to bed
rest or sitting too long without moving, such as during travel.

-Family history of blood clots

- A history of deep vein thrombosis (DVT) or pulmonary embolism (PE)

- Recent surgery or trauma

- Cancer or other serious illness

- Immobility (e.g. prolonged bed rest)

- Use of oral contraceptives or hormone replacement therapy

- Pregnancy and the postpartum period

- Obesity

- Smoking

- Age (the risk increases with age)

- Personal or family history of blood clotting disorders.

Risk factors
- Heart failure

- Heart valve disease

- High blood pressure

- Sickle cell disease

- Autoimmune disorders

- Connective tissue disorders

- Inflammatory bowel disease

- Crohn's disease

- Lupus

- Rheumatoid arthritis.

In addition to these medical conditions, certain medications can also increase the risk of developing an
embolism. These include:

- Estrogen-containing drugs (e.g. birth control pills)

- Tamoxifen

Pre disposing factors for venous thrombosis

Age:being older man over 60 increases the risk of deep vein thrombosis but it can take place at any age

Lack of movement: when legs do not move for a long time the muscles don't squeeze or contract yet
muscle contraction help blood flow . Sitting for a long period of time ,such as when driving or flying
increases the risk of deep vein thrombosis and also a long term bed rest which can be as a result from a
longing hospital stay or a medical condition such as paralysis

Injury or surgery: this increases the risk of blood clots due to the body going into a state called hyper
coagulability
Pregnancy : pregnancy also increases the vein pressure in the pelvis and legs and the risk can continue
for up to six week after a baby is born and others have inherited clotting disorder.

Being overweight / obese : this increases the pressure in the veins in the pelvis and legs

Smoking: this affects how blood flows and clots which increases the risk of vein thrombosis

Cancer : some cancer increases substances in the blood thus causes the blood to clot and some types of
cancer treatment also increases the risk of blood clots

Heart failure : this also increases the risk of deep vein thrombosis and pulmonary embolism because the
heart and the lungs don't work well in people with heart failure

Inflammatory bowel disease : Crohn's disease or ulcerative colitis increases the risk of deep vein
thrombosis

Genetic: some people have DNA changes that causes the blood to clot more easily and example is factor
v Leiden which is an inherited disorder on its own might not cause blood clots unless combined with
other risk factors

Pulmonary hypertension: this condition develops when the blood in the lungs don't dissolve properly
causing damages and scarings to the blood vessels lead to shortness of breath and fatigue

Complication embolism
Cardiac arrest

This can be as a result of the blockage of the artery that supplies blood to the heart cause a sudden stop
breathing of the heart
Pleural effusion

This is a condition in which fluid build up in between the layers of pleura which are min membrane that
surrounds the lungs causes the patient to have dry cough and chest pain

Pulmonary infarction

This can be as a result of dead lungs tissue and this can occur when oxygenated blood is blocked from
reaching lung tissue and keeping it nourished . Typically it's a large clot that causes the
condition.pulmonary infarction develops slowly by the outcome include coughing up blood ,sharp chest
pain and fever

Cardiac arrhythmia

It is a term to describe any abnormal heart rhythm or exceedingly fast heart beat which is tachycardia
which is a heart beat that is chaotic

Pulmonary hypertension

This is the blood pressure in the pulmonary artery which carries blood from the heart to the lungs that
is higher than normal because of increased pressure that makes it harder for the heart to pump blood
to the lungs and leading to damage of the blood vessels in the lungs. When the blood vessels are
damaged they are more likely to become clogged with clots.

Pulmonary embolism

It is a blood clot that breaks off from the vein and move through your blood stream so it end partly or
completely blocking an artery in the lungs e.g it causes sudden cough , which may be bloody, rapid
breathing or sudden shortness of breath even when resting and also chest pain

Post thrombotic syndrome

This occurs when the body immune system over reacts to blood clot. When the clots stay in the leg or
arm for too long it can damage the vein or valves thus causes a back flow of blood to the pool, instead
of pushing it towards the heart . post thrombotic is mild but some symptoms can be severe e .g pain ,
swelling,Darkened skin color , skin sores and varicose vein

Phleg cerulean dolens

It is a massive deep vein thrombosis that most often occurs in upper leg if left untreated and this can
lead to venous gangrene which causes massive tissue death. This also comes from the condition called
phlegmasia alba dolen which means painful white inflammation which comes from clot in a deep leg
vein that block blood flow as a result the leg is swollen white and painful , such condition occurs in
pregnant women that are in the mid trimester or after they give birth

Nursing problems and nursing diagnosis of embolism

1. Acute pain - acute pain related to decreased myocardial oxygenation

2.Impaired gas exchange - impaired gas exchange related to alveolar - capillary membrane changes

3. Activity intolerance - Activity intolerance related to oxygen demand imbalance evidenced by low
oxygen saturation

4. Decreased cardiac output - Decreased cardiac output related to right ventricular failure secondary to
acute pulmonary hypertension

5. Risk for shock - Risk of shock related to potential right sided heart failure
: Signs and symptoms of embolism

1. Shortness of breath due to blockage of blood flow in the lung,which makes it harder for the lungs to
get the oxygen they need.

2. Chest pain due to lack of oxygen and blockage of blood flow in the lungs.

3. Coughing out blood due to blockage of blood flow in the lung causing damage to the tissue,leading to
bleeding.

4. Hypotension due to lack of oxygen in the blood,which causes the blood vessels to dilate and blood
pressure to drop.

5. Fast heart rate (tachycardia)due to body’s response to the lack of oxygen in blood,which triggers the
release of hormones that cause the heart to beat faster.

PATHOPHYSIOLOGY
Embolism occurs when a blood clot or other foreign material,like fat or air,gets lodged in a blood vessel
and blocks the flow of blood. This can happen in different parts of the body,like the lungs,brain,or heart.
It can be pretty serious and cause symptoms like chest pain,difficulty breathing,or even a stroke and
involves a combination of factors,including blood stasis,vessels wall injury,and hyper-coagulability.
When blood flows slows down or becomes stagnant,it can lead to the formation of a clot. Injury to the
vessel wall can trigger clotting.Additionally certain conditions of factors can make the blood more prone
to clotting.

Signs and symptoms of venous thrombosis

1 common symptoms include;swelling,pain,and redness in the affected area or leg. This occurs because
the blood clot blocks blood flow,which can cause the tissue to swell and become inflamed.
2 Skin to be discolored,usually red or blue. This is because the blood clot can block the return of oxygen-
poor blood to the heart,causing the skin to appear bluish in color.

Medical management for venous embolism and thrombosis

(1) Aims

- promotion of healing

- maintaining blood circulation,open airways

- assess level of consciousness

- to return the patient to a state of health

- to promote comfort and relief pain

(2) history taking

-chief complaint( what brought patient to hospital)

-Demographic data( name, age ,sex occupation, marital status, location , next of kin number, address

-familly history ( TB,sickle cell,anaemia , cardiac dzz,

- social history ( occupation, environment status, number of family members to he or she stay with,
number of meals per day)

- obtretic data( if a patient had undergo operation or surgery)

-medical history ( current medication taken,allergies,any side effects

(3) physical exam

- inspection

Appearance of patient

- colour of hair for nutritional status, hygiene

-colour of eyes to rule out jaundice and anaemia

- any scars

- palpation

(Any bulge

- lumbs

-oedimatus)

- percution

(Sounds from card/labdub

- fluids in body areas

- normal sounds of stomach)

-Auscultation ( heart rate

- lung sounds

- breathings

(4) investigation

- fbc( complete blood count test)

- duplex ultrasonography (to detect blood blockages or clots )

- contrast venography (an x ray to see the flow of blood in vein)

(5) pharmacology

- edoxaban( 60 mg/ oral/OD

- rivaroxaban( prevent reccurent / 25mg/3 weeks/BD

-dabigatran(direct thrombin inhibitors 75mg/BD

- Apixaban /oral/BD/2.5mg/selective and reversible inhibitor

Non pharmacological

- iv fluids eg normal saline for electrolyte balance

- drinking a lot of fluids ( dehydration

- fruits for vitamins

Balanced diet to remain nourished-

OPERATIVE NURSING CARE

Aims

:To adequately prepare the client emotionally and physically for operation

To manage pain

To prevent post-operative complicationsTo familiarize the patient to hospital environment

nTo manage painTo prevent post-operative complications

To familiarize the patient to hospital environment

To obtain a consent form

To resuscitate the patient

Environment

I will admit my patient in the surgical ward for a specialized clinical attention

I will dump dust the room with sodium hypochlorite 0.5% to prevent bacteria colonisations.

I will nurse the patient in a well lit room for easy observation of the patient

.I will nurse the patient in a well ventilated room to allow free air circulation and for patient’s
comfortability.

Investigations.

I will collect Blood for grouping, preparation in advance and cross match..

I will do Chest x-ray to rule out chest conditions.

I will carry out Urine examination for microscopy, culture and sensitivity, glucose and other
abnormalities

.I will collect Blood for clotting timeI will do Haemoglobin test to rule out anaemia

I will Blood test for platelet countPosition

I will nurse my patient in a position of s/his comfortable position to avoid irritations

.I will be changing my patient’s position two hourly to prevent pressure sores

Observations

I will monitor patient’s vital signs in general to detect any deviation from normal.

I will check and record temperature to detect hyperthermia which may indicate presences of infections.

I will check and record pulse and blood pressure to detect hypotension which may compromise surgery

.I will observe the patient for cyanosis to detect impaired tissue perfusion which may indicate
respiratory conditions.

I will observe the general condition of the patient to note whether the patient can undergo surgery

Psychological care

.I will explain to the client and the family that surgery will be in the best interest of the client to facilitate
cooperation and client’s involvement in his/her own careI

I will explain the level at which the operation will be done to help allay anxiety

I will explain the possibility for any prosthesis aid in the rehabilitation phase to give client hope for
independence and thereby allay anxiety.

I will give the patient opportunity to think about the operation and where possible, allow patient to see
those with prosthesis people who has undergone same operation for emotional support and allay
anxiety.

I will involve significant relations for emotional, physical and economical support

I will involve employers, if client is employed, to allay anxiety regarding risk for job loss

I will let the patient speak out his mind to allay anxiety and promote cooperation

Consent form signing

I will explain the condition and the need for the operation as the only best option in simple language to
enable him/hr understand fully and arrive at the suggestion

I will explain to the patient the importance of signing the consent form that it acts as the legal document
between the hospital and the patient to prevent wrong operation on the patient.

I will advise the patient’s relatives to sign the consent, if he is below 18 years as per hospital policy

Nutrition

I will give my patient small frequent meals to promote appetite as more energy is needed before
surgery

I will give the patient food rich in carbohydrates to provide energy in readiness for surgery

I will give the patient a high protein diet to enhance healing during post-operative care

I will provide the patient with food rich in vitamins supplements and minerals to boost the immunity

Iwill give my patient fluids to keep him hydrated during h/her stay in hospital

Exercise

I will involve the physiotherapists to explain to the patient on what is expected on him in term of
physical wellbeing in post-operative care

I will encourage him/hr to do active exercise such walking around the hospital to prevent complication
and to promote normal blood circulation before operation

Hygiene

I will give my patient an assisted or bed bath, depending on his condition, to promote hygiene.

I will provide oral care to prevent halitosis and promote comfort.

I will do bed making daily to promote comfort and hygiene.

I will do hair care to promote general hygiene

.I will do nail care; cut them short and remove nail polish to prevent diarrhea diseases

I will change bed linen whenever they are soiled or dirty for cleanliness to promote comfort
Rest

I will restrict visitors to avoid noise thereby promoting rest to the patient as my patient requires more
rest before surgeryl

I will nurse the patient in a well-lit environment to promote rest and for easily observation.If my patient
is in too much pain,

Iwill administer prescribed analgesia as prescribed such as pethidine to relieve pain and promote rest to
the patient

I will do all related clinical procedures on my patient at once to promote rest

Elimination

I will provide urinals or bed pan if patient is bedridden to avoid soiling linen

Iwill catheterize the patient to avoid urine incontinence.

Emergency preoperative care

Aims

Prepare the patient for surgeryTo stabilize the patient before surgery can be undertaken

To prevent complications*

Maintaining airway and adequate breathing

(I)I Will position the patient in proper position such as lateral or supine with head lifted to one side , to promote drainage of
circulation

(ii) I will do suctioning of the secretion with the suctioning machine to remove secretions and thereby promoting patients
airway

(iii) I will give oxygen therapy 51 /mm to correct tissue hypoxia

(iv) I will monitor respirations by using a pulse oximeter to rule out this dyspnea and low saturation*MAINTAINING
CIRCULATION

(I)I will cannulate the patient with 16-18 cannulate to facilitate rapid infusion of fluid

(ii)I will give intravenous fluid like normal saline to rehydrate the patient and improve blood volume
(iii)I will give blood transfusion where indicated to I improve hemoglobin levels and correct anemia

(iv)I will monitor pluse and blood pressure to rule out bradycardia and tachycardia and hypotension

ADMINISTRATION OF RESUCITATIVE DRUGS

(I)I will prescribed resucitative drugs where indicated,such adrenaline hydrocortisone to promote blood flow

(ii)I will give 50%dextrose for energy

PSYCHOLOGICAL CARE

(I)I will provide information on the types of surgery she is to undergo , for example where and how that surgery will be done
some expectations of that surgery particularly ,it benefit in comparison to other forms of treatment without causing UN due
anxiety.this will be done using a simple lauguage which is clearly for the patient to understand

(ii)I will provide her with an opportunity to ask questions to express there fears or anxiety as verbalizing can help reduce
tension prior and during surgery if there are any patient nearby who has a similar operation and are recovering wel

l.(iii)I will introduce the patient to another patient that undergone surgery so that they can have a chat and share her
experience

(iv)I will also consider the relative and significant other in the care plan for the patient so that it helps in promoting the sense
of belonging, This will help her uplift herself concept and love feeling

(V)I will explain all procedures to be done to her in advance to gain her cooperation

(Vi) I will maintain privacy at all times and liver realistic wishes respected to gain her cooperation and build self esteem

OBTAINING A CONSENT FORM

(I)I will give sufficient information to the client or patient throughout the pre operation and I will ask the attending physician
to explain the need for operation , this is to enable her obtain at least a verbal content for the operation and also to make an
informed decision

(ii) I will ask the patient to sign the content form if she is 18 years or above if this is under age the relative or the medical
superintendent will sign

(iii) I will ask the patients to use fingerprint if she is unable to write to obtain consent

(iv) I will counter sign as a witness and the doctor will sign as indicating nature of operation to be done

(V) I will explain to the patient that signing of the consent form means that she has fully understood all relevant surgical
anesthetic proceeding and relevant intervention to be carried out

INVESTIGATION

(I) I will collect blood for hemoglobin and cross match to know the hemoglobin levels and also to know the blood group

(ii) if will escort the patient for ultrasound scan to rule out the abnormalities

(iii) I will escort the patient for x-rays to rule out the abnormality
(iv)I will do history taking to know how the problem started

(V)I will do physical examination to escertain where the problem is

(Vi) I will collect urine for urinalysis to rule out diatbetis mellitus

(Vii) I will do history taking which will reveal pain

(Viii)I will do physical examination which will reveal palpable mass abdominal distension

OBSERVATION

I will take observation at the vital signs of temperature, pulse, blood pressure and respirationsThis will act as baseline data
and will also help bme monitoring the progress or change in the condition of any patient.any significant deviation of vitals
signs will promptly be reported to the doctorI will also monitor the patient reaction to the idea of surgery

.I will check if the patient is in pain and take appropriate pain relief measure

PhYSICAL PREPARATION

I will assist the anesthetist in assessing the patient whether the is fit to undergo surgery or notI will give the prescribed pre-
medication by the anesthetist like atropine 0.4mg to dry up secretion during surgery

BOWEL PREPARATION

Iwill begin the bowel preparation where

I will insert a nasal gastric tube to aspirate the content at the stomach .so as to prevent vomiting and aspiration

I will also administer prescribe antibiotics for sterilizing the abdomen

SKIN PREPARATION

I will give antiseptic bath or shower a day prior to surgery or in the morning of the day of surgery to cleanse her of micro
bacteria from the body

I will shave or trim the site of operation ,

I will clean the shaven site with an antiseptic solution and leave it dry

I will provide a clean gown to be worn over on the body to allow the skin to remain clean

BLADDER CARE

I will ask my patient to empty the bladder in the morning before surgery

I will also put an indwelling catheter to allow continuous draining of the urine this is important as it prevent accidental
perforation of the bladder in abdominal surgery it also helps t monitor the status of urinary output during surgery

NTRAVENOUS INFUSION OR NUTRITION

I will put an intravenous infusion line for administration to solution and medication during surgery

I will put an intravenous line to provide a quick access of the vein when I want to resucitate the patientI will put an
intravenous line to provide mean and providing nutrition

GOWNIING

will give a gown and a head dress to cover there hair this is to limit micro organism from the head and body to contaminate
the incision site

MEDICAL RECORDS

will arrange all the necessary medical records for the patient,all the labs and x-ray results which were ordered ,by the doctor
and nurse documents to avoid complications

IDENTIFY BAND

I will place a name Tay identify band on the patients forehead or arm bearing her name sex ,age,and type of operation to be
done for identification

REMOVAL OF VALUABLES

I will remove the entire valuable such as rings , hair piece , dentures or jewelry as some of these may easily have station
electricity in an environment where there will be high concentration of oxygen. some metal valuable also can cause
accidental burns or electric shock to the patient

ESCORTING THE PATIENT

I will gather all the patients documents and escort the patient to theatreI will be on the headside while pushing the trolley
to monitor the patient and for psychological care

PREPARATION OF A POSTOPERATIVE BED AND REQUIREMENTS AND CARE OF RELATIVES

I will prepare a post operative bed and resucitative requirements

I will inform the relative of the impending transfer of the the patient to theatre and ask them to wait for their patient in a
waiting room for the return of their relative to allay anxiety

I will put an intravenous line to provide a quick access of the vein when

I want to resucitate the patient

I will put an intravenous line to provide mean and providing nutrition

GOWNING

will give a gown and a head dress to cover there hair this is to limit micro organism from the head and body to contaminate
the incision site
MEDICAL RECORDS

I will arrange all the necessary medical records for the patient,all the labs and x-ray results which were ordered ,by the
doctor and nurse documents to avoid complications

IDENTIFY BANDI

I will place a name Tay identify band on the patients forehead or arm bearing her name sex ,age,and type of operation to be
done for identification

REMOVAL OF VALUABLES

will remove the entire valuable such as rings , hair piece , dentures or jewelry as some of these may easily have station
electricity in an environment where there will be high concentration of oxygen. some metal valuable also can cause
accidental burns or electric shock to the patient

ESCORTING THE PATIENT

I will gather all the patients documents and escort the patient to theatreI will be on the headside while pushing the trolley
to monitor the patient and for psychological care

PREPARATION OF A POSTOPERATIVE BED AND REQUIREMENTS AND CARE OF RELATIVES

I will prepare a post operative bed and resucitative requirements

I will inform the relative of the impending transfer of the the patient to theatre and ask them to wait for their patient in a
waiting room for the return of their relative to allay anxiety

POST OPERATIVE CARE

Objectives

To prevent complications

To maintain psychological stability.

To promote quick recovery

To give heath education to the patient

Environment and Ventilation

I will make a post operative bed and put accessories such as bed elevators, drip stand and suction machines in place

. Before collecting the patient from the theatre

I will ensure that the room is warm to prevent hypothermia.

I will make sure that the room is well ventilated to promote free flow of air.
Iwill dump dust the room with sodium hypochlorite 0.5% to prevent bacteria colonisations

.I will nurse the patient in a well lit room for easy observation of the patient

.I will nurse the patient in a well ventilated room to allow free air circulation and for patient’s comfortability

I will make sure that the room is quiet to promote rest this will be achieved by playing radios and TVs at
low volume

Position

I will put my patient on a wreckled free post operarative bed to prevent discomfort

I will make sure that my patient is positioned in right position with head tilt to allow free flow of
purulent

I will encourage my patient to use the trapezium initially with assistant to change position

I will change my patient position 2 hourly to prevent pressure sore

I will ensure patient airway is clear to prevent respiratory complications

Observations

: I will observe for vital signs (temperature, pulse, respiration and blood pressure) of my patient that’s
1/4 hourly then half hourly for baseline data

I will assess for Low blood pressure if any deviation from normal

I will give IV fluids such as normal saline to raise the blood pressure to normal ranges

I will observe that the bandage if too tight to interfere with normal circulation

I will apply pressure on the wound by putting a well folded towel in between two sand bags to rest the
stump

I will observe for signs of pain and give appropriate measures such as pethidine 100mgs PRN.

I will check for the presence of infection on the wound for early treatment

Pain Relief

I will give prescribed analgesics such as pethidine 100 mgs PRN to relief pain
I will change my patients position to reduce discomfortness and pain arising from bony prominence
pressure

.I will give Minor transquillisers may be given, with continued psychological care.

Care of wound/ infection prevention

In the 72nd hour the surgeon may remove the 1st dressing

. Cleaning and dressing aseptically will be done to prevent infection

I will observe for bleeding from the wound, which could be from a loosed suture by collaborating with
vital signs for early treatmentI will place Bed Craddle to lift the weight of beddings and prevent
complication.

I will observe the change of colour of bandage as this may indicate infection.

I will avoid opening the dressing or bandage any how to prevent infection from setting in.

I will administer prophylactic broad spectum antibiotics as ordered to prevent infection

I will dress the wound as ordered and left the bandage intact in all the 48 hours to promote healing

I will follow aseptic technics when dressing the wound to avoid introducing other infections

Iwill advise vistors and staffs to follow aseptic techqnics when visiting the patient to prevent the
introduction of other infections

Psychological care:

I will always be understanding if change of behavior is seen e.g. crying, withdrawal, depression as
operation causes severe grieving

Iwill be they for him in time of need to create an accepting and supportive atmosphere to the patient

I will involve the clergy man for Spiritual care and assurance

I will be a good listener to his need to promote cooperation

I will explain the use of cradles, sand bags, drains, and bed elevation for co-operation

.I will involve relatives in the care of the patient to my him not to feel neglectedI will encourage a
positive outlook by inviting other patients with a similar disability to allay anxiety

I will begin rehabilitation and other support measures early to allow my patient to copy up
Exercise and Ambulation

I will do Chest exercises to prevent hypostatic pneumonia

.I will Passive exercises of other limbs to prevent contractures and promote blood circulation.

Nutrition

I will give my patient small frequent meals to promote appetite

I will give the patient food rich in carbohydrates to provide energy

I will give the patient a high protein diet to enhance healing.

I will provide the patient with food rich in vitamins supplements and minerals to boost the immunity

.I will give my patient fluids to keep him hydrated

Elimination:

I will give plenty oral fluids to wash and prevent urinary tract infection

I will give a laxative to promote opening bowels

.I will observe for urine output bowel movement to rule out any abnormalitiesHygiene:

I will give my patient an assisted or bed bath, depending on his condition, to promote hygiene

.I will provide oral care to prevent halitosis and promote comfort.

I will do bed making daily to promote comfort and hygiene.I will do hair care to promote general
hygiene.

I will do nail care; cut them short and remove nail polish to prevent diarrhea diseasesI will change of
linen whenever they are soiled or dirty for cleanliness to promote comfortHealth

education

: I will advise my patient not to smoke for at least 6 weeks or stay in a smoky environment as smoke can
irritate the eye hence delay in wound healing.
I will Not to use soap for at least 6 weeks when washing the wounde as soap will irritate the eye and the
wound healing may be delayed or the wound may be infected.

I will explain to my patient to avoid shaking the operated site as this increases and may irritate the
wound.I will Teach hm/hr how to wrap and clean the wound following aseptic technique for her/hs
participation while t home in hs/hr care.

I will Advise patient to care for the other limb to prevent injury

.I will encourage my patient to report for any complications for early treatment

Complications

CHappens when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a
blockage called pulmonary embolism (PE). If the clot is small, and with appropriate treatment, people
can recover from PE. However, there could be some damage to the lungs. If the clot is large, it can stop
blood from reaching the lungs and is fatal.

In addition, one-third to one-half of people who have a DVT will have long-term complications caused by
the damage the clot does to the valves in the vein called post-thrombotic syndrome (PTS). People with
PTS have symptoms such as swelling, pain, discoloration, and in severe cases, scaling or ulcers in the
affected part of the body. In some cases, the symptoms can be so severe that a person becomes
disabled.

Nursing problems and nursing diagnosis of embolism

1. Acute pain - acute pain related to decreased myocardial oxygenation

2.Impaired gas exchange - impaired gas exchange related to alveolar - capillary membrane changes
3. Activity intolerance - Activity intolerance related to oxygen demand imbalance evidenced by low
oxygen saturation

4. Decreased cardiac output - Decreased cardiac output related to right ventricular failure secondary to
acute pulmonary hypertension

5. Risk for shock - Risk of shock related to potential right sided heart failure

6. Impaired comfort - Impaired comfort related to vascular inflammation and irritation evidenced by
patient

7 neffective tissue perfusion - Ineffective tissue perfusion related to interruption of venous blood flow
evidenced by edema

Signs and symptoms of embolism

1. Shortness of breath due to blockage of blood flow in the lung,which makes it harder for the lungs to
get the oxygen they need.

2. Chest pain due to lack of oxygen and blockage of blood flow in the lungs.

3. Coughing out blood due to blockage of blood flow in the lung causing damage to the tissue,leading to
bleeding.

4. Hypotension due to lack of oxygen in the blood,which causes the blood vessels to dilate and blood
pressure to drop.

5. Fast heart rate (tachycardia)due to body’s response to the lack of oxygen in blood,which triggers the
release of hormones that cause the heart to beat faster.