A client with severe osteoarthritis has been treated with total hip replacement. Which intervention will the nurse implement to help protect against the risk for deep venous thrombosis (DVT)?

Use of sequential compression devices (SCDs) during times of rest

Use of abductor pillow while in bed

Keeping the heels elevated

Opioid pain medications as ordered

Early ambulation and leg exercises

Answer and Explanation

The Correct Answer is E

Choice A reason: Use of sequential compression devices (SCDs) during times of rest is a helpful intervention to prevent DVT, as it improves the venous return and reduces the stasis of blood in the lower extremities. However, it is not the only or the most effective intervention, as it does not promote the active contraction of the leg muscles.

Choice B reason: Use of abductor pillow while in bed is a necessary intervention to prevent hip dislocation after total hip replacement, as it maintains the alignment and stability of the hip joint. However, it is not a specific intervention to prevent DVT, as it does not enhance the blood circulation or prevent the formation of clots.

Choice C reason: Keeping the heels elevated is a useful intervention to prevent pressure ulcers on the heels, as it reduces the friction and shear forces on the skin. However, it is not a relevant intervention to prevent DVT, as it does not affect the venous flow or prevent the clotting of blood.

Choice D reason: Opioid pain medications as ordered are an important intervention to manage the postoperative pain after total hip replacement, as they provide analgesia and sedation. However, they are not a direct intervention to prevent DVT, as they do not influence the blood coagulation or prevent the thrombus formation. In fact, they may increase the risk of DVT by causing respiratory depression, hypotension, and immobility.

Choice E reason: Early ambulation and leg exercises are the most effective interventions to prevent DVT, as they stimulate the contraction of the leg muscles and improve the blood flow in the veins. They also prevent the pooling and clotting of blood in the lower extremities.

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Correct Answer is E

Explanation

Choice A reason: Increased circulation of the calf is not a sign or symptom of DVT, but a normal finding of the blood flow in the leg. It can be assessed by palpating the pulses, checking the capillary refill, or observing the skin color and temperature.

Choice B reason: Pale-appearing calf is not a sign or symptom of DVT, but a sign of arterial insufficiency or ischemia. It indicates the reduced blood supply and oxygen delivery to the tissues, which can cause pain, numbness, or coldness of the leg.

Choice C reason: Increased warmth in the calf is not a specific sign or symptom of DVT, but a possible sign of inflammation or infection. It may be accompanied by redness, swelling, or fever, which can indicate a local or systemic inflammatory response.

Choice D reason: Loss of sensation to the calf is not a sign or symptom of DVT, but a sign of nerve damage or compression. It may be caused by trauma, injury, diabetes, or other conditions that affect the peripheral nervous system.

Choice E reason: Swelling and tenderness of the calf is a common sign or symptom of DVT, as it indicates the presence of a blood clot in the deep veins of the leg. It may also cause pain, cramping, or heaviness of the leg, which can worsen with movement or standing.

A. Atopic dermatitis B. Cellulitis C. Seborrheic keratosis D. Pemphigus E. Lymphedema

Correct Answer is E

Explanation

Choice A reason: Atopic dermatitis is not a likely explanation for the assessment findings, as it is a chronic inflammatory skin condition that causes itching, scaling, and dryness of the skin, usually on the face, neck, and flexural areas.

Choice B reason: Cellulitis is a possible explanation for the assessment findings, as it is a bacterial infection of the skin and subcutaneous tissues that causes warmth, redness, swelling, and pain of the affected area. However, it is not the most likely explanation, as it usually occurs as a result of a break in the skin, such as a wound, insect bite, or ulcer, which is not mentioned in the scenario.

Choice C reason: Seborrheic keratosis is not a relevant explanation for the assessment findings, as it is a benign skin growth that causes brown, black, or tan lesions that have a waxy or scaly appearance, usually on the face, chest, or back.

Choice D reason: Pemphigus is not a plausible explanation for the assessment findings, as it is a rare autoimmune disorder that causes blisters and erosions of the skin and mucous membranes, usually on the trunk, scalp, or mouth.

Choice E reason: Lymphedema is the most likely explanation for the assessment findings, as it is a condition that causes swelling of the arm due to impaired lymphatic drainage after mastectomy surgery. It can also cause warmth, redness, and tenderness of the affected limb.

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A client with severe osteoarthritis has been treated with total hip replacement. Which intervention will the nurse implement to help protect against the risk for deep venous thrombosis (DVT)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is E

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