S11 · Likely to develop blood clots
Risk Safety and protection
Definition
Limited movement, surgery, or illness raise the chance of clots in the veins.- Surgery
- immobility
- long travel
- cancer
- dehydration
- previous clot
- Swelling, pain, redness, or warmth in one leg
- sudden chest pain
- breathlessness
📋 Scenario
A patient is bedbound two days after hip surgery.
Subjective (S): "My legs feel fine, but I cannot move much."
Objective (O): Two days after hip surgery; mostly bedbound; both calves soft, not swollen, tender or warm; no chest pain; drinking little.
Assessment tools for this scenario: CP-SAFE Safety & Falls Score CP-PAIN Pain & Comfort Score
Validated scales to consider: Morse Fall Scale, NRS 0–10, FLACC, PAINAD
**CarePath diagnosis:** Likely to develop blood clots related to surgery, immobility and poor fluid intake (risk factors); no signs of the problem are present yet.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Give clot prevention as ordered. | Clot prevention medicine or devices reduce the blood's tendency to clot while the patient is still, as after surgery. |
| Encourage early movement and fluids as allowed. | Movement and fluids keep blood flowing through the leg veins and prevent blood thickening, lowering clot risk. |
| Check both legs each shift for swelling, pain, redness or warmth. | Comparing both legs shows early signs of a clot, such as swelling, pain, redness or warmth, which often affect one leg. |
| If one leg is swollen, tender or warm: do not massage it or apply stockings; keep the patient resting and call the doctor urgently. | Massage could dislodge a clot and send it to the lungs, and stockings are not applied over a possible clot, so rest and urgent medical review are safest. |
| Report chest pain or breathlessness at once as an emergency. | Chest pain or breathlessness may mean a clot has reached the lungs, which is life-threatening and needs emergency help. |
**Expected outcomes**
- No leg swelling, chest pain or breathlessness during the stay.
- Clot prevention given on time.
- Patient walks as allowed and drinks fluids.
- Any leg change is reported within the shift.
**Linking the data to the diagnosis**
Two days after hip surgery the patient is mostly bedbound and drinking little, and says their legs feel fine but they cannot move much. Both calves are soft, not swollen, tender or warm, and there is no chest pain. No clot is seen, so this is a risk diagnosis resting on surgery, immobility and poor fluid intake. If a leg becomes swollen or chest pain appears, help is called urgently. The plan aims for no leg swelling, chest pain or breathlessness, clot prevention given on time, walking and drinking as allowed, and any leg change reported within the shift.
CarePath diagnosis
Likely to develop blood clots related to surgery, immobility and poor fluid intake (risk factors); no signs of the problem are present yet.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Give clot prevention as ordered. | Clot prevention medicine or devices reduce the blood's tendency to clot while the patient is still, as after surgery. |
| 2. Encourage early movement and fluids as allowed. | Movement and fluids keep blood flowing through the leg veins and prevent blood thickening, lowering clot risk. |
| 3. Check both legs each shift for swelling, pain, redness or warmth. | Comparing both legs shows early signs of a clot, such as swelling, pain, redness or warmth, which often affect one leg. |
| 4. If one leg is swollen, tender or warm: do not massage it or apply stockings; keep the patient resting and call the doctor urgently. | Massage could dislodge a clot and send it to the lungs, and stockings are not applied over a possible clot, so rest and urgent medical review are safest. |
| 5. Report chest pain or breathlessness at once as an emergency. | Chest pain or breathlessness may mean a clot has reached the lungs, which is life-threatening and needs emergency help. |
Expected outcomes
- No leg swelling, chest pain or breathlessness during the stay.
- Clot prevention given on time.
- Patient walks as allowed and drinks fluids.
- Any leg change is reported within the shift.
Linking the data to the diagnosis
Two days after hip surgery the patient is mostly bedbound and drinking little, and says their legs feel fine but they cannot move much. Both calves are soft, not swollen, tender or warm, and there is no chest pain. No clot is seen, so this is a risk diagnosis resting on surgery, immobility and poor fluid intake. If a leg becomes swollen or chest pain appears, help is called urgently. The plan aims for no leg swelling, chest pain or breathlessness, clot prevention given on time, walking and drinking as allowed, and any leg change reported within the shift.