A nurse with 10 years of experience attends a hospital-required training session and learns a new method for securing Foley catheters to the leg after insertion. During the training, the nurse educator provides the nurse with a bibliography of current peer-reviewed articles related to Foley catheter securement devices. The nurse recognizes the change in procedure is developed from which method?

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.

Choice A reason: Reporting any pain that is uncontrolled by elevating the affected limb or by analgesic agents is an appropriate teaching point for the nurse to emphasize, as it may indicate a serious complication such as compartment syndrome, infection, or nerve damage. The nurse should instruct the client to notify the health care provider immediately if the pain persists or worsens.

Choice B reason: Using intermittent heat packs as prescribed to control swelling is not an appropriate teaching point for the nurse to emphasize, as it may increase the blood flow and inflammation in the affected area. The nurse should advise the client to avoid heat sources such as heating pads, hot water bottles, or electric blankets, as they may also damage the cast or cause burns.

Choice C reason: Using a small hair brush to control any itching under the cast is not an appropriate teaching point for the nurse to emphasize, as it may cause skin irritation, infection, or damage to the cast. The nurse should suggest the client to use a cool air dryer, a gentle tapping, or an antihistamine to relieve the itching, and to avoid inserting any objects under the cast.

Choice D reason: Keeping the affected extremity below the level of the heart to prevent swelling is not an appropriate teaching point for the nurse to emphasize, as it may impair the venous return and increase the edema. The nurse should recommend the client to elevate the affected extremity above the level of the heart to reduce the swelling and promote the healing.

Choice E reason: Inspecting the cast daily for cracks, breaks, or signs of infection is not an appropriate teaching point for the nurse to emphasize, as it is not a specific or relevant instruction for the client with a cast on his leg. The nurse should teach the client to keep the cast dry and clean, to cover it with a plastic bag when showering or bathing, and to report any foul odor, drainage, or fever.