Preventing DVTs & Pulmonary Emboli

Preventing DVTs and pulmonary emboli in hospitalized patients.

ADVANCE for Nurses—July 13, 2010

Preventing deep venous thromboses (DVTs) and pulmonary emboli (PEs) is one of the constant challenges facing nurses specializing in critical care.

Regina Cannon-Drake, MA, RN, a patient educator at Hospital for Special Surgery (HSS) in Manhattan, NY, described the proactive regimen used for patients scheduled for elective total hip or knee replacement.

"As part of our preop education program, we discuss complications like DVTs and PEs, and describe what we expect them to do postoperatively to lower their risk for those problems," she said. "We explain that the patients need to perform lower leg exercises and we'll be getting them up and moving around very soon after surgery to promote good circulation. We also review the use of mechanical compression devices (foot or calf pumps), and discuss anticoagulants that they'll be taking."

Cannon-Drake emphasized the importance of patient and family education. "We let patients know they'll be on anticoagulants for 4-6 weeks after their procedure, and teach them about warning signs of side effects," she said.

"We explain to them that those on Coumadin will need blood test monitoring (INR levels) twice a week and many will be eligible for a technician from homecare services to come their homes to draw the blood," she continued. "Also, someone from their doctor's office will call to confirm the dose of their anticoagulant. We also talk about what foods to eat and medications to avoid while they're on these medications."

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