You’re helping Mr. Henderson with his morning care when you notice his left calf looks swollen and feels warm to the touch. He mentions it hurts a little when he walks. These are classic warning signs of a thrombus, a serious condition that requires your immediate attention and reporting skills.
What is Thrombus?
A thrombus (THROM-bus) is a blood clot that forms inside a blood vessel and stays there. Think of it like a clog in a pipe—it blocks the normal flow of blood. This is different from an embolus, which is a clot that moves through the bloodstream. A thrombus usually forms in the deep veins of the legs (Deep Vein Thrombosis or DVT) due to sluggish circulation, especially in residents who are bedbound or sit for long periods.
Why Thrombus Matters in Your Daily Care
Your role in preventing and detecting thrombi is life-saving. If a clot breaks loose, it can travel to the lungs and cause a pulmonary embolism, a fatal emergency. By encouraging movement and performing range-of-motion exercises, you keep blood flowing. When you spot the early signs of a clot, you alert the nurse so treatment can begin before the clot dislodges. You are the first line of defense against this silent killer.
What You’ll See During Your Shift
During baths or dressing changes, you might notice that one leg is larger than the other, or the skin looks red and shiny. The area might feel unusually warm or tender when you touch it. The resident may complain of pain or cramping in the calf that doesn’t go away.
“Hey Sarah, I was changing Mrs. Alvarez’s TED hose and noticed her right calf is swollen and red compared to the left. She says it’s sore when I touch it. I didn’t massage it, but I wanted you to take a look right away.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Massaging a red, swollen calf. It might be your instinct to rub a sore area to comfort the resident, but massaging a limb with a thrombus can dislodge the clot and cause it to travel to the lungs.
Pro Tip: Always compare one limb to the other. If you see swelling, redness, or feel warmth in one leg but not the other, report it immediately. Use a tape measure if your facility protocol requires it, but your eyes and hands are your best tools for spotting differences.
Memory Aid for Thrombus
Think: “Thrombus is Stationary.”
Both words start with sounds that remind you of staying still (Thrombus/Stationary). This helps you remember that a thrombus is the clot that stays put in the vessel, unlike an embolus which is on the move.
State Test Connection
Expect questions on identifying signs and symptoms of Deep Vein Thrombosis (DVT). You will likely be asked what to observe for (redness, swelling, pain) and the critical action to take (reporting to the nurse immediately, never massaging the area).
Related Care Concepts
Understanding thrombus connects directly to Deep Vein Thrombosis (DVT) (the condition caused by the clot), anti-embolism stockings (TED hose) (used to prevent clots), and range of motion exercises (active or passive movement to keep blood flowing). It also relates to post-operative care (surgical patients are at high risk) and fluid intake (dehydration thickens blood and increases clot risk).
Quick Reference
✓ Key signs: Unilateral swelling, redness, warmth, tenderness in calf or leg ✓ When to report: Immediately upon noticing any difference between limbs ✓ Care reminders: • Do NOT massage the affected limb • Encourage fluid intake if not restricted • Perform range of motion exercises as ordered • Apply or remove TED hose per care plan • Compare legs daily during care routines
Bottom line: When you spot the signs of a thrombus, you are protecting your resident from a life-threatening emergency. Trust your eyes and report it fast.