rhabdomyolysis question

Columnist · Oct 17, 2012

Moved to Nursing Student Assistance for more response.

FLmed · Oct 17, 2012

Was this patient on a medication to help lower cholesterol- a statin?

DawnJ · Oct 17, 2012

I don't know, but my logical puzzling of the question says: could the clot have caused muscle to die and then cascaded to rhabdo?

Could be genetic or viral/bacterial too, I think. So maybe unrelated to the clot entirely.

First year student here, so interested in the answer too!

aachavez · Oct 17, 2012

I'm in med-surg 1, so this is all pretty new to me too. There's no detail of how his rahbdo came about, just that it is in his history. So it may be totally unrelated to his clot. While doing research I did find that a clot can lead to rhabdo, but couldnt seem to find why.

DawnJ's response seems to make sense to me.... the clot stopped blood flow, muscle tissue started to die, and ended up turning into rhabdo.

I was just curious how a blood clot could cause rhabdo, and it sounds like this is it. Unfortunetly there's no way of knowing this patients particular situation without any further detail.

Esme12, ASN, BSN, RN · Oct 17, 2012

What else is this patients history? What meds are they on? When was the rhabdo? Where was the Blood clot" What other co-morbidities exist.

Esme12, ASN, BSN, RN · Oct 17, 2012

Had the patient fallen at sometime and laid for an extended period of time until found?

AgentBeast, MSN, RN · Oct 17, 2012

The DVT generally would have to be in one of the major veins of the legs to cause Rhabdo. The Rhabdo might be related to the DVT and it might not. Where was the DVT, what was the patient's hydration status? I/O? Medications? PMH? Labs? So many questions and so few answers.

psu_213, BSN, RN · Oct 17, 2012

Had the patient fallen at sometime and laid for an extended period of time until found?

You beat me to it...

Is there anything that suggest the clot is related to the rhabdo? In and of itself, the clot itself does not cause rhabdo.

It you wanted to stretch it you could say that the clot was a PE, which caused hypoxemia, which led to the pt falling, which led to the rhabdo.

It could have been that a DVT caused swelling to the point that circulation to a limb was decreased to a level that muscle died.

Or the 2 could be totally unrelated.

aachavez · Oct 17, 2012

My question was more general, as in... How can a blood clot lead to rhabdo?

I am curious about this patient in particular, unfortunetly MANY details are not available in his chart. It was a few years ago, he also has a fall history, but dont know when that was. Insulin dependant diabetic for 25+ years, obese 72-yo male. Dont know when or where his DVT was, he is in a w/c but is able to move from bed to chair. I know, SOOO many questions that just arent answered in the chart (we've come to realize this is normal at this facility)

But essentially, it lookns like my question has been answered.... a severe DVT and the resulting lack of blood to muscle tissue would cause necrosis, tissue death, eventually leading to rhabdo. Rhabdo is kinda interesting to me now that I have learned just a teeny bit about it, may do a patho paper on it.... :) thanks for all the input, wish I had more info about this specific case, y'all are so helpful it would be awesome to get some other input for this care plan. But thanks for the info!

aachavez · Oct 17, 2012

It could have been that a DVT caused swelling to the point that circulation to a limb was decreased to a level that muscle died.

This is exactly what I was looking for. With the lack of info I can get on his history I know it's going to be pretty impossible to really get a definite answer on his specific case. I never would have thought about DVT and rhabdo as possibly being related, a good example of how one thing can lead to another.

aachavez · Oct 17, 2012

FLmed: Yes! He is currently on Simvastatin for cholesterol. Looking up the drug, under the warning symptoms to look out for are the symptoms of rhabdo... hmmm, this is interesting!... Yes I definetly see further research into rhabdo and a paper in my near future!