The nurse has reviewed the Provider Prescriptions at 1600.

Exhibits
Which of the following interventions should the nurse implement for the client with deep vein thrombosis? Select all that apply.

Encourage the client to elevate their legs while in bed.

Place an immobilizer on the affected leg.

Implement bleeding precautions.

Apply intermittent pneumatic compression devices to the unaffected leg.

Instruct the client to expect dark stools.

Answer and Explanation

Correct Answer : A,C,D

Rationale:

A. Encourage the client to elevate their legs while in bed: Elevating the affected leg helps reduce venous pressure, decreasing edema and discomfort associated with DVT. Elevation also promotes venous return, which can limit further clot propagation. This intervention provides symptom relief without increasing the risk of embolization.

B. Place an immobilizer on the affected leg: Immobilizers restrict movement and are used for musculoskeletal injuries, not for DVT management. Immobilization can worsen venous stasis by reducing circulation in the lower extremity. Instead, clients with DVT benefit from gentle mobility once anticoagulation is initiated, unless contraindicated, to prevent worsening clot burden.

C. Implement bleeding precautions: The client has diagnostic confirmation of DVT and will require anticoagulation, which increases bleeding risk. Bleeding precautions help prevent complications such as hematuria, bruising, or gastrointestinal bleeding. Monitoring for signs of bleeding and avoiding trauma are essential once therapy begins.

D. Apply intermittent pneumatic compression devices to the unaffected leg: IPC devices should not be applied to the affected limb due to the risk of dislodging the thrombus. However, using them on the unaffected leg promotes venous return and helps prevent additional clot formation.

E. Instruct the client to expect dark stools: Dark stools can indicate gastrointestinal bleeding, which is not an expected effect of DVT treatment. While anticoagulants can increase bleeding risk, the nurse should teach the client to report black or tarry stools immediately.

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Correct Answer is C

Explanation

Rationale:

A. Metoclopramide: Metoclopramide is an antiemetic and prokinetic agent used to treat nausea and gastroparesis. It is not classified as a controlled substance because it does not have potential for abuse or dependence.

B. Dantrolene: Dantrolene is a muscle relaxant used to treat spasticity and malignant hyperthermia. It is not a controlled substance as it has low potential for abuse or addiction.

C. Midazolam: Midazolam is a benzodiazepine used for sedation, anesthesia, and seizure management. Benzodiazepines are classified as controlled substances due to their potential for dependence, abuse, and misuse, making midazolam a controlled drug.

D. Ketorolac: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term pain management. It is not a controlled substance because it has minimal risk for abuse or dependence.

A. Forearm B. Ventrogluteal C. Outer posterior aspect of upper arm D. Vastus lateralis

Correct Answer is C

Explanation

Rationale:

A. Forearm: The forearm is not a recommended site for subcutaneous injections because it has limited subcutaneous tissue and is typically reserved for intradermal injections, such as allergy testing or tuberculosis screening.

B. Ventrogluteal: The ventrogluteal site is preferred for intramuscular injections due to the large muscle mass and low risk of nerve injury. It is not suitable for subcutaneous injections, which require fatty tissue rather than muscle.

C. Outer posterior aspect of upper arm: This site contains adequate subcutaneous tissue, is easily accessible, and is commonly used for subcutaneous injections such as insulin or heparin. It allows for proper absorption and minimizes the risk of intramuscular administration.

D. Vastus lateralis: The vastus lateralis is part of the thigh and is primarily used for intramuscular injections, especially in infants or adults needing large-volume IM medications. It is not a typical site for subcutaneous injections.

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The nurse has reviewed the Provider Prescriptions at 1600.

Exhibits
Which of the following interventions should the nurse implement for the client with deep vein thrombosis? Select all that apply.