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)?

Use of sequential compression devices (SCDs) during times of rest

Use of abductor pillow while in bed

Keeping the heels elevated

Opioid pain medications as ordered

Early ambulation and leg exercises

Answer and Explanation

The Correct Answer is E

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.

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Correct Answer is B

Explanation

Choice A reason: Institute of Medicine (IOM) research is not a method for developing procedures, but an organization that conducts health-related studies and provides recommendations for improving health care quality and safety.

Choice B reason: Evidence-based practice is the correct method for developing procedures. It is the process of integrating the best available research evidence with clinical expertise and patient preferences to make decisions about health care.

Choice C reason: Knowledge, skills, and attitude are not a method for developing procedures, but the components of competency that nurses need to provide safe and effective care.

Choice D reason: Core measures are not a method for developing procedures, but a set of standardized performance indicators that evaluate the quality of care for specific conditions or procedures.

A. Pain management B. Improvement of joint mobility C. Client will recover from osteoarthritis within 6 months D. Weight loss promotion E. The client will deny symptoms of osteoarthritis

Correct Answer is B

Explanation

Choice A reason: Pain management is an important goal for a client with osteoarthritis, but it is not the only one. The question asks for what goals the nurse should include, not what is the most essential or urgent goal.

Choice B reason: Improvement of joint mobility is a correct goal for a client with osteoarthritis, as it helps to prevent stiffness, contractures, and deformities of the affected joints. It also improves the client's function, quality of life, and independence.

Choice C reason: Client will recover from osteoarthritis within 6 months is not a realistic or attainable goal, as osteoarthritis is a chronic and progressive condition that has no cure. The nurse should focus on managing the symptoms and preventing complications, not on curing the disease.

Choice D reason: Weight loss promotion is a relevant goal for a client with osteoarthritis, especially if the client is obese, as it helps to reduce the stress and pressure on the weight-bearing joints. However, it is not a specific or measurable goal, as it does not indicate how much weight the client should lose or how the nurse will monitor the progress.

Choice E reason: The client will deny symptoms of osteoarthritis is not a desirable or appropriate goal, as it implies that the client is not honest or aware of their condition. The nurse should encourage the client to report any symptoms or changes in their joints, as it helps to assess the effectiveness of the treatment and to adjust the plan of care accordingly.

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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)?

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