Palpate leg with caution. The area can feel warm and patients may experience pain or discomfort during drug administration (nurses should assess if this pain persists between administrations). DecafMom. Maintain/enhance tissue perfusion, facilitate resolution of thrombus. Loewenstein R (2011) Treatment of superficial thrombophlebitis. The Phlebitis Scale was developed by the Infusion Nurses Society (2006). New England Journal of Medicine; 364: 4, 380. Engage in behaviors/activities to enhance tissue perfusion. A patient with phlebitis with a VIP score of 2 or more will require their cannula to be removed or resited. Mechanical phlebitis occurs where the movement of a foreign object (cannula) within a vein causes friction and subsequent venous inflammation (Stokowski et al, 2009) (Fig 1). The incidence of phlebitis can be reduced by use of simple measures. Diagnosis and nursing intervention / treatment of DVT, thrombophlebitis. Early phlebitis at an intravenous site usually resolves after a cannula is removed or resited (Rickard et al, 2010). The patient’s urinary output is 15ml per hour. Likewise, central access is required if cytotoxic and/or hypertonic solutions are to be intravenously administered (RCN, 2010). It is shown in Box 3. Phlebitis has been linked with inappropriate catheter insertion sites and inappropriate catheter usage. Isotonic fluids have been found to lower rates of phlebitis, while hypertonic fluids increase the incidence of phlebitis by initiating the inflammatory response (Uslusoy and Mete, 2008). Good staff hygiene, hand hygiene and adherence to universal precautions (Box 2) are fundamental nursing skills that have consistently been shown to reduce cross-infection, improve hospital hygiene and help combat nosocomial infections (Burke, 2003). Nursing diagnosis for postpartum thrombophlebitis: altered peripheral tissue perfusion may be related to interruption of venous flow possibly evidenced by edema of affected extremity; erythema (superficial thrombophlebitis) or pallor and coolness (DVT), diminished peripheral pulses, pain. An aseptic technique is necessary when performing any clinically invasive procedure, especially if the patient has an infectious disease. A significant number of patients admitted into hospital receive some form of intravenous therapy via PVC.

Note guarding of extremity.

In addition, a poor standard of infection control has a part to play and infection control and hygiene standards are essential in the treatment and prevention of the condition (Uslusoy and Mete, 2008). 4. Nursing Diagnosis: Acute pain Treatment: Antiembolism stockings are applied bilaterally to improve venous return and decrease the risk of DVT formation. Webster J et al (2010) Clinically-indicated replacement versus routine replacement of peripheral venous catheters. The inflammation is due to irritation of the tunica intima by mechanical, chemical or bacterial sources. Disease process/prognosis and therapeutic needs understood Monitor vital signs, noting elevated temperature. The VIP score is recommended in the Infusion Nursing Standards of Practice (INS, 2011). Rationale: Minimizes the possibility of dislodging thrombus and creating emboli.

Intravenous therapy is indicated for many reasons. DVT: Pulmonary embolism (PE) develops when a bloodborne substance lodges in a branch of a pulmonary artery and obstructs flow. Rationale: Elevations in heart rate may indicate increased discomfort or may occur in response to fever and inflammatory process.
Anti-inflammatory analgesics can be prescribed to treat both the inflammation and the pain associated with phlebitis. A number of phlebitis scales and assessment tools have been developed to assist this, and the two most commonly used in the UK are the Phlebitis Scale and the Visual Infusion Phlebitis (VIP) scale.

Rationale: These measures are designed to increase venous return from lower extremities and reduce venous stasis, as well as improve general muscletone/strength. 1. 4. The appropriate cannula should be selected for the vein. Journal of the American Academy of Nurse Practitioners; 20: 172-180. Superficial thrombophlebitis is seen more often during the postpartal period than during pregnancy and is more common in women with preexisting varices. Thrombosis that involves only the superficial veins of the leg or thigh is unlikely to generate pulmonary emboli (PE). Thi... Postpartal hemorrhage is usually defined as the loss of more than 500 ml of blood during or after delivery.

Keywords Phlebitis, Venous catheter, Infection control. Rationale: Cradle keeps pressure of bedclothes off the affected leg, thereby reducing pressure discomfort. Visit our, Phlebitis: treatment, care and prevention, 100 years: Centenary of the nursing register, 2020: International Year of the Nurse and Midwife, Nursing Times Workforce Summit and Awards, print-friendly PDF file of the complete article, Winners of the 2020 Student Nursing Times Awards revealed, First trust pledges support for Nursing Times staff wellbeing campaign, Announcing our Student Nursing Times editors for 2020-21, Don’t miss your latest monthly issue of Nursing Times, Expert nurses share their knowledge of pressure ulcers in free-to-watch videos, Known Covid-19 nurse death toll ‘now equal that from WW1’, Night shift nurses ‘most ill-served’ by hospital food facilities, Covid-19 admission risk ‘three times higher’ for patient-facing staff, RCN deputy president ‘left with no choice’ but to resign, ‘We know the mental and emotional toll of the pandemic is starting to show’, Nursing Times survey reveals views on flu and Covid-19 vaccines, ‘Imposter syndrome made me dread some of my lectures’, Nurse and Theatre Practitioner Opportunities, This content is for health professionals only, Peripheral venous cannulation is a common procedure used in hospital to deliver fluid and medicine, Phlebitis (inflamation of the vein) can be caused by chemical, mechanical or infectious irritation, Good practice with cannula insertion and infection control should help to prevent the condition, Peripheral venous cannulation is a common procedure, Phlebitis – or inflammation of the vein – can be caused by mechanical, chemical or infectious irritation at the cannula site, Careful placement and good hygiene can help to prevent phlebitis, There are two assessment tools to identify early signs of the condition, Vigilance can help to prevent rare but potentially severe complications such as sepsis.

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