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DVT & PE: Safe Nursing Decisions

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DVT/PE

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DVT & PE: Safe Nursing Decisions
 

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DVT & PE: Safe Nursing DecisionsVersión en línea

DVT/PE

por RNPRPEPBESTIE
1

A 64 - year - old client is on postoperative day three following a total hip replacement . The client has remained mostly in bed due to pain and reports a feeling of tightness in the left calf while attempting to reposition . The nurse notes mild swelling of the lower leg and warmth to touch . Vital signs are stable . The client asks if it would help to massage the sore area to improve comfort .

The nurse understands the priority response is to .

2

A 70 - year - old client is admitted following surgical repair of a fractured femur . The client has remained mostly in bed and requires assistance for repositioning . During the evening assessment , the nurse notes the right lower leg appears larger than the left and is warm to touch . The client reports a dull aching discomfort behind the knee that increases when the leg is placed in a dependent position .

The nurse understands the most appropriate next action is to .

3

A 48 - year - old client is preparing for discharge after hospitalization for treatment of a confirmed deep vein thrombosis . The client has been prescribed an oral anticoagulant and states plans to return to a desk job that requires sitting for long periods . During discharge teaching , the client asks what can be done to reduce the chance of another clot forming .

The nurse understands the priority teaching is to .

4

A 59 - year - old client is hospitalized following abdominal surgery . The client has been progressing with mobility and pain control . During the night shift , the client suddenly reports feeling short of breath and appears anxious while attempting to sit up in bed . The nurse notes a rapid pulse and observes the client taking shallow breaths .

The nurse recognizes the priority action is to .

5

A 73 - year - old client is admitted with swelling and discomfort of the lower leg . The provider documents concern for possible deep vein thrombosis and writes new activity orders . While reviewing the chart , the nurse notes an order encouraging the client to ambulate in the hallway three times daily . The client reports persistent calf tenderness when attempting to move the leg in bed .

The nurse understands the priority action is to .

6

A 67 - year - old client is receiving anticoagulant therapy following treatment for a pulmonary embolism . During the morning assessment , the nurse observes new ecchymosis on the client ? s arms and continued oozing from a recent venipuncture site . The client reports feeling increasingly weak and slightly dizzy when standing . Blood pressure is lower than earlier readings and the pulse is mildly elevated .

The nurse understands the priority action is to .

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