A nurse is planning care for a client who has deep vein thrombosis of the lower leg. Which of the following interventions should the nurse include in the plan of care?

Apply ice packs to affected leg.

Keep the client's affected leg elevated while in bed.

Have the client ambulate prior to applying antiembolic stockings.

Massage the client's affected leg twice a day.

Answer and Explanation

The Correct Answer is B

A. Apply ice packs to affected leg: While ice can help reduce swelling and pain in some conditions, it is not typically recommended for deep vein thrombosis (DVT) because it could increase the risk of clot dislodgement.
B. Keep the client's affected leg elevated while in bed: Elevating the leg helps reduce swelling and promotes venous return, which is important in managing DVT.
C. Have the client ambulate prior to applying antiembolic stockings: Ambulation is usually avoided initially in the presence of DVT until anticoagulation therapy is started to reduce the risk of clot dislodgement. Antiembolic stockings should be applied after anticoagulation therapy is initiated.
D. Massage the client's affected leg twice a day: Massaging the affected leg is contraindicated in DVT as it can increase the risk of dislodging the clot, leading to complications such as pulmonary embolism.

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Correct Answer is []

Explanation

Atrial fibrillation is characterized by an irregular, often rapid heart rate that can lead to poor blood flow. The client's symptoms of a "fluttering" and "racing" heartbeat, dizziness, and shortness of breath, along with the irregular cardiac rhythm and unclear P waves, are indicative of atrial fibrillation.
Obtaining a 12 lead ECG is essential to confirm the diagnosis and assess the extent of the arrhythmia.
Administering an anticoagulant is crucial to prevent thromboembolic events, such as stroke, which are common complications of atrial fibrillation.
Monitoring for manifestations of stroke is important because atrial fibrillation increases the risk of stroke.
PT/INR should be monitored to ensure the effectiveness and safety of anticoagulant therapy.

A. WBC count 20,000/mm3 B. Potassium 3.8 mEq/L C. Hematocrit 40% D. Creatinine 0.9 mg/dL

Correct Answer is A

Explanation

A. A WBC count of 20,000/mm3 is elevated, which suggests the presence of infection or inflammation. This is concerning and should be reported to the surgeon, as an infection or other underlying issue could delay or contraindicate surgery.
B. A potassium level of 3.8 mEq/L is within the normal range (3.5–5.0 mEq/L). It does not require immediate intervention and is not a concern for surgery.
C. A hematocrit of 40% is within the normal range for an adult female (typically 36–48%), so it does not require intervention.
D. A creatinine level of 0.9 mg/dL is normal for most adults (0.6–1.2 mg/dL), suggesting normal kidney function and not requiring any intervention.

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