Venous Thromboembolism: Very Troubling Events
The goal of this article is to inform nurses about prevention strategies and the
types of anticoagulants used for prevention and treatment of Venous Thromboembolism (VTE).
Venous Thromboembolism (VTE) is the number-one cause of preventable death in
hospitalized patients. A thrombus is a clot that forms in a blood vessel, most often
in a deep vein, which results in deep vein thrombosis (DVT). The danger lies in
the thrombus breaking loose from the vein and traveling through the right side of the
heart to the lungs, resulting in a pulmonary embolism (PE). This process is different
from a thrombus that forms in an artery and results in a myocardial infarction or
cerebral vascular accident.
Beyond the immediate dangers, both DVT and PE can produce longlasting debilitating
effects. Chronic thromboembolic pulmonary hypertension, which develops in about 5% of
individuals who survive a PE, is characterized by progressive dyspnea, eventually
leading to right-sided heart failure. After a DVT, around one-third of patients will
develop post-thrombotic syndrome with chronic lower-extremity edema, pain, and skin
changes that can progress to weeping ulcerations. More than 20% of patients
with proximal DVT (thrombus located in the popliteal, femoral, or iliac veins) or PE
will suffer a recurrent event after discontinuing anticoagulation, and patients may
experience loss of function, financial burdens from treatment, and fear of
Key Learning Outcomes
- Explain how to assess patients for risk of venous thromboembolism (VTE).
- Describe strategies to prevent VTE.
- Discuss treatment of VTE.
Carolyn E. Crumley, DNP, RN, ACNS-BC, CWOCN
Dr. Crumley is an adjunct assistant professor and clinical nurse specialist program
coordinator at the University of Missouri-Columbia. She’s also a wound, ostomy, and
continence nurse at Saint Luke’s East Hospital in Lee’s Summit, Missouri.