Nursing care for a child with Thrombophlebitis

Gowri. M¹, Alfiya.A², Yashoda.K^3*

¹Paediatric ward Staff Nurse, Kauvery hospital, Salem

²Paediatric ward Staff Nurse, Kauvery hospital, Salem

³Deputy Nursing Superintendent, Kauvery Hospital, Salem.

*Correspondence: M – 9500779605;

Background

A 9 years old child presented with complaints of swelling of left upper limb and pain for 4 days along with history of fever and cough. She had superficial thrombophlebitis (SVT) following previous IV cannulation outside hospital.

On examination

Redness, swelling, tenderness and warmth of left upper limb. There was also pitting edema.

Vital signs

Temperature – 102°f
Pulse – 130beats/min
Respiration – 26 breaths / min
Blood pressure – 100/60 mmHg
SpO2- 99 % in room air
GCS: Patient conscious oriented
Vaccination: vaccinated for age.

Investigations

Hemoglobin – 8.4 gm/dl
Total WBC count – 25320 cells cumm
Platelet count – 3.17 lacks
CRP – 174
Sputum – AFB negative
X ray chest – bilateral patchy changes
Blood culture – no growth
Doppler USG left upper limb – normal study and diffuse subcutaneous edema
Echo – normal chambers.

Immediate management

She was started on Inj Meropenam500mg thrice a day for 8 days
Inj Linocid 200mg twice a day for 8 days
Inj Para 250mg q6h
IV fluids

Nursing management

Ice pack compression on admission was applied 3hourly and later from 2^nd day thrice a day.
Magnesium sulphate dressing was applied for 6 hr for 4 days until the swelling reduced.
Elastic compression bandage was also applied
Soft ball exercise for the fingers

Day – 4

On the day of discharge, her swelling reduced drastically and she had a gradual recovery. She was discharged as per doctor’s advice.

Discharge treatment

Drug	Dose	Frequency
Tab. Linezolid	300 mg	OD
Tab. Faropenam	100 mg	BD
Syp. Tonoferon paediatric	5 ml	OD
Syp. Zincovit	5 ml	OD
Syp. Rantac	5 ml	OD (before food).

Conclusion

Proper hand hygiene and the use of clean gloves to handle IV connectors and devices are important in preventing IV associated infections. If thrombophlebitis is due to IV cannula, the cannula must be removed. Any cannulation or IV set must be changed on the third day of insertion or if there is swelling or if the patient complaints of pain. The cannula site/IV site must be labeled with the date of insertion for proper monitoring and follow-up.