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https://doi.org/10.15836/ccar2022.341

Nursing care of a patient with deep vein thrombosis treated with Alteplase – case overview

Tanja Mikulandra orcid id orcid.org/0000-0003-2766-1653
Nevenka Vila orcid id orcid.org/0000-0002-6169-3491


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Abstract

Keywords

deep vein thrombosis; nursing care; alteplase

Hrčak ID:

290028

URI

https://hrcak.srce.hr/290028

Publication date:

8.12.2022.

Visits: 655 *



Introduction: Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein and obstructs the normal blood flow. (1,2) 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 illnesses, disability, and in some cases, death. Assessment of the venous thrombosis in the Republic of Croatia is about 160/100,000, which assumes about 6,500 new cases per year in the total population. The incidence grows exponentially with age and at the age of 80 it occurs in 5/1000 people. According to guidelines, warfarin and new oral anticoagulants (NOAC) are used to treat DVT. This paper will present the course of DVT treatment with alteplase, which is not the standard procedure in DVT treatment, and the importance and role of a nurse in the care of the patient.

Case report: 48-year-old person was hospitalized at the Department of Cardiovascular Diseases with a case of iliofemoral DVT. The patient checked in the emergency ward due to swelling, pain, and paresthesia in her left leg. At the time of arrival, the patient was contactable, oriented, eupneic, afebrile, normotensive and normohydrated. Despite administered therapy, leg pain was getting stronger, the leg was extremely swollen, and pulsation was getting weaker. The patient was visibly upset and thought she would lose her leg. A nurse talked with the patient and managed to get her to relax. The patient was transferred to the Coronary Care Unit so she can be administered with Alteplase. After the therapy administration the patient stopped feeling strong pain and started to feel better. Two days after therapy the redness and swelling of the leg disappeared. The patient was verticalized with an elastic bandage and was able to walk with the help of a nurse.

Conclusion: Treating DVT with alteplase is a much quicker and more efficient way to treat this disease and the adequate patient preparation significantly lowers the fear of the outcome of the disease. No matter how well-acquainted the patients are with their disease and its possible outcomes, they always look for support and understanding. Nursing care and education of the patient with DVT is of key importance in understanding their condition and accepting treatment and possible outcomes.

LITERATURE

1 

Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous thromboembolism: a public health concern. Am J Prev Med. 2010 April;38(4) Suppl:S495–501. https://doi.org/10.1016/j.amepre.2009.12.017 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/20331949

2 

Banfić Lj. Guidelines on diagnosis, treatment and prevention of venous thrombosis. Cardiol Croat. 2016;11(9):351–74. https://doi.org/10.15836/ccar2016.351


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