Thrombophlebitis occurs when there is an inflammation of a vein with formation of a clot occurs. Most thrombophlebitis occurs in the lower extremities, with the saphenous vein being the most common vein affected. Homan's sign is an assessment tool used for many years by healthcare workers to detect deep vein thrombi. It is considered positive if the client complains of pain on dorsiflexion of the foot. Homan's sign should not be performed routinely because it can cause a clot to be dislodged and lead to pulmonary emboli. If a diagnosis of thrombophlebitis is made, the client should be placed on bed rest with warm, moist compresses to the leg. An anticoagulant is ordered, and the client is monitored for complications such as cellulitis. If cellulitis is present, antibiotics are ordered.
Antithrombolitic stockings or sequential compression devices are ordered to prevent venous stasis. When antithrombolitic stockings are applied, the client should be in bed for a minimum of 30 minutes prior to applying the stockings. The circumference and length of the extremity should be measured to prevent rolling down of the stocking and a tourniquet effect.