Which nursing intervention is essential to prevent pressure ulcers in a patient with limited mobility?

Performing frequent and thorough skin assessments.

Applying petroleum jelly to vulnerable areas.

Placing the patient on an air mattress.

Encouraging the patient to sit for prolonged periods.

Answer and Explanation

The Correct Answer is A

Performing frequent and thorough skin assessments is essential for identifying early signs of pressure ulcers and implementing appropriate preventive measures in patients with limited mobility.

Incorrect choices:

b. Applying petroleum jelly to vulnerable areas may create a barrier but does not address the underlying issue of pressure and does not substitute for regular skin assessments and preventive measures.

c. Placing the patient on an air mattress can provide pressure redistribution, but it should be used based on individualized assessment and healthcare provider recommendations. Skin assessments remain essential.

d. Encouraging the patient to sit for prolonged periods increases the risk of pressure ulcers. Adequate repositioning and regular mobilization should be prioritized to prevent skin breakdown.

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Correct Answer is B

Explanation

Patients who undergo surgery are at an increased risk for developing deep vein thrombosis (DVT) due to the immobility associated with the postoperative period.

Incorrect choices:

a. While hypertension is a risk factor for cardiovascular diseases, it does not increase the risk of DVT specifically.

c. Regular exercise is a protective factor against DVT, as it promotes circulation and venous return.

d. Diabetes is a risk factor for peripheral vascular disease, but it does not directly increase the risk of DVT.

A. Encouraging frequent ambulation and leg exercises. B. Administering sedatives to promote restfulness. C. Applying cold compresses to the lower extremities. D. Limiting fluid intake to prevent swelling.

Correct Answer is A

Explanation

Encouraging frequent ambulation and leg exercises helps prevent venous stasis and promotes blood flow, reducing the risk of venous thromboembolism (VTE) in immobile patients.

Incorrect choices:

b. Administering sedatives can increase the risk of VTE by promoting immobility and reducing leg movement. It is not an appropriate preventive measure.

c. Applying cold compresses to the lower extremities does not directly prevent VTE. Warm compresses may be used to promote circulation, but prevention strategies primarily focus on mobilization and blood flow promotion.

d. Limiting fluid intake does not directly prevent VTE. Adequate hydration should be maintained to promote circulation and prevent complications such as dehydration and urinary tract infections.

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Which nursing intervention is essential to prevent pressure ulcers in a patient with limited mobility?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which patient is at the greatest risk for developing deep vein thrombosis (DVT) due to immobility?

Correct Answer is B

Explanation

Which intervention is important for preventing venous thromboembolism (VTE) in an immobile patient?

Correct Answer is A

Explanation

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