A nurse is caring for a client who is wearing antiembolic stockings. Which of the following interventions should the nurse include in the plan of care?

Determine if the stockings are binding.

Fold the top of the stocking over neatly.

Apply the stockings after the client is in a chair.

Massage the client's legs once every 8 hr while the stockings are in place.

Answer and Explanation

The Correct Answer is A

A. Determine if the stockings are binding. It is important to assess that antiembolic stockings are not too tight, especially around the top, as this can impair circulation. Proper fit ensures they function effectively to promote venous return and prevent deep vein thrombosis.
B. Fold the top of the stocking over neatly. Folding or rolling the tops can cause constriction and act like a tourniquet, reducing circulation and increasing the risk of complications such as venous stasis or skin breakdown.
C. Apply the stockings after the client is in a chair. Antiembolic stockings should be applied while the client is lying down, before getting up, to prevent blood pooling in the legs. Applying them after the client is upright may reduce their effectiveness.
D. Massage the client's legs once every 8 hr while the stockings are in place. Massaging the legs, especially in clients at risk for thrombosis, is not recommended as it could dislodge a clot and lead to embolism. Passive or active leg movement is safer and more effective.

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Correct Answer is A

Explanation

A. Critical pathways should reduce health care costs. Critical pathways, also known as clinical pathways or care maps, are evidence-based, multidisciplinary plans that outline expected care and outcomes for specific conditions. They aim to improve care efficiency, reduce complications, and lower healthcare costs by standardizing care.
B. Nurses should discontinue the critical pathway if variances occur. Variances—deviations from the expected pathway—are documented and analyzed, not a reason to discontinue the pathway. They help identify areas for improvement or necessary adjustments in patient care.
C. Critical pathways have an unlimited timeframe for completion. Critical pathways are time-bound, with specific goals and milestones to be met within a set timeframe based on typical recovery patterns for the condition being treated.
D. Nurses' notes are used to create the critical pathway. Critical pathways are developed using evidence-based guidelines, expert consensus, and clinical research, not individual nurses’ progress notes. However, nurses do document progress and variances within the pathway.

A. Weak femoral pulses B. Increased intracranial pressure C. Upper extremity hypotension D. Frequent nosebleeds

Correct Answer is A

Explanation

A. Weak femoral pulses. Coarctation of the aorta is a congenital narrowing of the aorta, which leads to reduced blood flow to the lower extremities, resulting in weak or absent femoral pulses—a hallmark finding of this condition.
B. Increased intracranial pressure. This is not directly associated with coarctation of the aorta. While severe hypertension can lead to neurologic symptoms, increased ICP is not a typical or early finding.
C. Upper extremity hypotension. The condition causes hypertension in the upper extremities and hypotension in the lower extremities due to the location of the narrowing. Upper extremity hypotension would be an unexpected finding.
D. Frequent nosebleeds. While nosebleeds may occur in older children or adults with uncontrolled hypertension, they are not an expected finding in infants with coarctation of the aorta.

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A nurse is caring for a client who is wearing antiembolic stockings. Which of the following interventions should the nurse include in the plan of care?

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Naxlex Comprehensive Predictor Exams

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