A nurse recently hired to the preoperative area learns that certain patients are at higher risk for venous thromboembolism (VTE). Which patients are considered to be at high risk? (Select all that apply.)

Morbidly obese patient

A woman who smokes and takes oral contraceptives or smoke

Wheelchair-bound patient

Patient with a humerus fracture

Patient who underwent a prolonged surgical procedure

Answer and Explanation

Correct Answer : A,B,E

A. Morbidly obese patient: Obesity is a known risk factor for VTE due to several reasons. Morbidly obese individuals often have impaired mobility, which can lead to venous stasis (sluggish blood flow in the veins). Additionally, obesity is associated with inflammation and changes in blood clotting factors, increasing the risk of developing blood clots in the veins.

B. A woman who smokes and takes oral contraceptives or smokes: Both smoking and oral contraceptive use are independent risk factors for VTE. Smoking can cause damage to blood vessels and alter blood clotting mechanisms, while oral contraceptives can increase the risk of blood clots due to hormonal changes.

C. Wheelchair-bound patient: While being wheelchair-bound alone may not always indicate a high risk for VTE, immobility is a significant risk factor for developing blood clots. Prolonged periods of immobility can lead to blood stasis in the veins, making wheelchair-bound patients susceptible to VTE, especially if other risk factors are present.

D. Patient with a humerus fracture: A humerus fracture on its own may not necessarily increase the risk of VTE significantly. However, if the fracture requires immobilization or surgery, especially if it affects the lower extremities or leads to prolonged immobility, the risk of VTE can increase due to decreased blood flow and stasis.

E. Patient who underwent a prolonged surgical procedure: Prolonged surgical procedures often involve anesthesia, immobility during surgery, and postoperative immobilization, all of which can contribute to venous stasis and increase the risk of developing VTE. Additionally, the surgical trauma itself can trigger inflammatory responses and alterations in blood clotting factors, further elevating the risk of blood clots.

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Correct Answer is C

Explanation

A. "Bake or grill the meat rather than frying it."

This statement is more related to reducing fat intake rather than managing sodium levels. While reducing fried foods can be beneficial for overall health, it doesn't directly address the issue of sodium intake, which is crucial in managing hypernatremia.

B. “Check your radial pulse twice a day.”

Checking the radial pulse is a method used to monitor heart rate and rhythm. It is not directly related to managing sodium levels or hypernatremia. Although monitoring vital signs is important in general health care, it is not specific to addressing mild hypernatremia.

C. "Read food labels to determine sodium content."

This statement is the correct choice. Managing sodium intake is a key component in managing hypernatremia. Reading food labels helps patients identify high-sodium foods and make choices that are lower in sodium content, which can be crucial in preventing or managing mild hypernatremia.

D. “Weigh yourself every morning and every night."

While regular weight monitoring can be important for certain health conditions, it is not directly related to managing mild hypernatremia. Weight changes may occur with fluid retention or loss, but monitoring sodium intake and hydration status is more directly relevant to managing hypernatremia.

A. “Call your surgeon if you have any questions at home.” B. ”Eat a diet high in protein, iron, zinc, and vitamin C.” C. “Wash your hands before touching the drain or dressing." D. “Be sure you keep all your postoperative appointments.”

Correct Answer is C

Explanation

A. “Call your surgeon if you have any questions at home.”

This instruction is important as it encourages the patient to seek help and clarification if they have any concerns or questions about their postoperative care at home. However, while communication with the surgeon is essential, it is not as immediately critical as ensuring proper hand hygiene when dealing with wound care and drain management.

B. ”Eat a diet high in protein, iron, zinc, and vitamin C.”

Nutritional advice is crucial for postoperative recovery, as a balanced diet high in protein, iron, zinc, and vitamin C can promote wound healing and overall recovery. However, while important for long-term recovery and healing, dietary recommendations do not directly address the immediate risk of infection or complications associated with wound care and drain management.

C. “Wash your hands before touching the drain or dressing."

This instruction is the most important in this context because proper hand hygiene is crucial for preventing infections during wound care and drain management. Clean hands significantly reduce the risk of introducing harmful bacteria or contaminants to the surgical site, which can lead to infections and other complications. Ensuring that the patient washes their hands before touching the drain or dressing is a fundamental measure for promoting wound healing and preventing postoperative complications.

D. “Be sure you keep all your postoperative appointments.”

Keeping postoperative appointments is important for ongoing assessment, monitoring, and follow-up care. However, while essential for overall recovery and management of postoperative issues, it is not as immediate or directly related to the patient's ability to manage their dressing and drain at home.

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A nurse recently hired to the preoperative area learns that certain patients are at higher risk for venous thromboembolism (VTE). Which patients are considered to be at high risk? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse teaches a patient who is at risk for mild hypernatremia. Which statement does the nurse include in this patient's teaching?

Correct Answer is C

Explanation

A nurse is preparing a patient for discharge after surgery. The patient needs to change a large dressing and manage a drain at home. What instruction by the nurse is most important?

Correct Answer is C

Explanation

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