A client with severe osteoarthritis has been treated with total hip replacement. Which intervention will the nurse implement to help protect against the risk for deep venous thrombosis (DVT)?

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: Client who is ambulatory demonstrating a steady gait is not a priority for the nurse. This client is stable and does not require immediate intervention.

Choice B reason: Client scheduled for physical therapy for the first crutch-walking session is not a priority for the nurse. This client is not in acute distress and can wait for the physical therapist to assist them.

Choice C reason: Postoperative client who has just received an opioid pain medication is not a priority for the nurse. This client is expected to have pain relief from the medication and can be monitored for adverse effects later.

Choice D reason: Client with onset of new chest pain is the priority for the nurse. This client is potentially experiencing a life-threatening condition such as a myocardial infarction or a pulmonary embolism. The nurse should assess the client's vital signs, oxygen saturation, and electrocardiogram, and administer oxygen, nitroglycerin, and aspirin as ordered.