A nurse is providing teaching to a patient with chronic venous insufficiency. Which of the following should be included in the teaching plan? (Select all that apply.)

Walking is contraindicated and bed rest as much as possible is recommended

Dangle" legs on the side of the bed several times per day

Avoid sitting or standing for prolonged periods

Elevate legs above heart level for 20-30 minutes. 4-5 times per day

Use compression stockings to decrease swelling

Answer and Explanation

Correct Answer : C,D,E

A) Walking is contraindicated and bed rest as much as possible is recommended:
. Walking is actually highly recommended for patients with chronic venous insufficiency (CVI). Gentle, regular physical activity, such as walking, helps improve circulation and reduce the risk of blood pooling in the lower extremities. Bed rest is not typically recommended unless the patient has severe symptoms like ulcers or active infection. In fact, staying active can promote better venous return and prevent worsening of CVI.

B) Dangle legs on the side of the bed several times per day:
. Dangling the legs can exacerbate venous stasis (blood pooling in the veins), which worsens symptoms of chronic venous insufficiency. Instead of dangling the legs, patients should focus on elevating the legs to reduce swelling and improve venous return. Dangle the legs only if advised by a healthcare provider for specific reasons, such as short periods of time to encourage blood flow after immobility.

C) Avoid sitting or standing for prolonged periods:
. One of the key recommendations for managing chronic venous insufficiency is to avoid prolonged sitting or standing. Remaining in one position for too long can cause blood to pool in the lower extremities, leading to increased swelling, pain, and discomfort. It’s important to encourage frequent position changes and movement, such as standing up or walking around if sitting, or sitting down to rest if standing for prolonged periods.

D) Elevate legs above heart level for 20-30 minutes, 4-5 times per day:
. Elevating the legs above heart level is a key intervention for patients with chronic venous insufficiency. This helps reduce swelling by promoting venous return and decreasing the pressure in the veins. Elevating the legs for 20-30 minutes, several times a day (4-5 times) can help alleviate symptoms and prevent further complications, such as ulcers and skin changes.

E) Use compression stockings to decrease swelling:
. Compression stockings are a cornerstone of managing chronic venous insufficiency. They help improve venous return, prevent blood from pooling in the lower legs, and reduce swelling. The stockings should be properly fitted and worn throughout the day (except when sleeping) to provide continuous support and minimize the risk of complications associated with CVI, such as venous ulcers.

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Correct Answer is D

Explanation

A. Slow, shallow respirations and low heart rate:
Slow, shallow respirations and a low heart rate are not typical signs of postoperative hemorrhage. These signs might suggest respiratory or cardiac issues, but they are not specific to hemorrhage. In fact, hemorrhage is more likely to result in tachycardia (increased heart rate) and hypotension (low blood pressure) rather than bradycardia (low heart rate). Therefore, this finding is not indicative of post-operative hemorrhage.

B. Fever and flushed skin:
Fever and flushed skin are more commonly associated with infection rather than hemorrhage. After surgery, fever can be a sign of infection, particularly if it occurs 24-48 hours postoperatively. While infection can sometimes cause a rise in heart rate, it does not directly correlate with the symptoms of hemorrhage. Therefore, fever and flushed skin are not the most indicative of hemorrhage in the immediate postoperative phase.

C. Disorientation and confusion in an elderly patient:
Disorientation and confusion in the elderly post-operative patient can be concerning and may be caused by a variety of factors, such as medication side effects, electrolyte imbalances, or postoperative delirium. While confusion can occur with significant blood loss, it is not a primary indicator of hemorrhage. The signs of hemorrhage are more likely to include changes in vital signs, especially heart rate and blood pressure. Therefore, while disorientation and confusion should be monitored, they are not the most definitive sign of hemorrhage.

D. Increasing heart rate and decreasing blood pressure:
Increasing heart rate (tachycardia) and decreasing blood pressure (hypotension) are classic signs of hemorrhage. When blood loss occurs, the body compensates by increasing the heart rate to maintain cardiac output and attempting to constrict blood vessels. As hemorrhage progresses, blood volume decreases, which leads to a drop in blood pressure. This combination of tachycardia and hypotension is a key indicator of significant blood loss and requires immediate assessment and intervention. Therefore, this is the most indicative finding of postoperative hemorrhage.

Correct Answer is ["8"]

Explanation

Given:

Total volume to infuse: 150 mL

Infusion time: 3 hours

Drop factor of tubing: 10 gtt/mL

To find:

Drip rate (gtt/min)

Step 1: Convert infusion time to minutes

3 hours x 60 minutes/hour = 180 minutes

Step 2: Calculate the total number of drops

Total drops = Total volume x Drop factor

Total drops = 150 mL x 10 gtt/mL = 1500 gtt

Step 3: Calculate the drip rate

Drip rate = Total drops / Infusion time in minutes

Drip rate = 1500 gtt / 180 minutes = 8.33 gtt/min

Step 4: Round to the nearest whole number

Since the question asks for the drip rate rounded to the nearest whole number, we round 8.33 to 8 gtt/min.

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A nurse is providing teaching to a patient with chronic venous insufficiency. Which of the following should be included in the teaching plan? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

The nurse is assessing a patient in the immediate post-operative phase. Which of thr following assessment findings would be most indicative of post-operative hemorrhage?

Correct Answer is D

Explanation

Correct Answer is ["8"]

Explanation

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