Deep vein thrombosis: anticoagulation

A deep vein thrombosis — a limb swollen, warm and tender on one side, confirmed by duplex ultrasound — is treated by anticoagulation that must run unbroken from the moment the clot is confirmed to the end of the prescribed course, so the nurse starts the ordered anticoagulant without delay, keeps the parenteral agent running through any transition to warfarin until the INR has held in the target range on consecutive readings because warfarin's protection is delayed and its first days do not anticoagulate, ends it early only for a direct oral anticoagulant that needs no parenteral lead-in, watches every phase for what goes wrong on either side — bleeding from the drug, a platelet count that falls on heparin, and embolism from the clot — and sends the patient home knowing that the tablets continue after the limb feels well, that nothing over the counter is added without asking, that vitamin K intake on warfarin stays steady rather than avoided, and that moving early and often rather than resting the limb is what prevents the next clot.