A nurse is planning postoperative care for a client following a total hip arthroplasty. What nursing interventions would help prevent venous thromboembolism for this client? (Select all that apply)

Early ambulation.

Fluid restriction.

Quadriceps-setting exercises.

Compression stockings/devices.

Anticoagulant drug therapy.

Answer and Explanation

Correct Answer : A,C,D,E

Choice A reason: Early ambulation post-hip arthroplasty promotes venous blood flow, reducing stasis, a key factor in Virchow’s triad for thromboembolism. Muscle contractions enhance circulation, preventing clot formation in deep veins, significantly lowering the risk of pulmonary embolism.
Choice B reason: Fluid restriction does not prevent venous thromboembolism and may increase blood viscosity, promoting clot formation. Adequate hydration supports circulation, reducing stasis, making fluid restriction counterproductive for preventing thromboembolism in postoperative clients.
Choice C reason: Quadriceps-setting exercises activate muscle pumps in the legs, promoting venous return and reducing blood stasis. This mechanical action prevents clot formation in deep veins, making it an effective intervention to lower thromboembolism risk post-surgery.
Choice D reason: Compression stockings/devices apply external pressure, enhancing venous return and preventing blood pooling in the legs. This reduces stasis, a major risk factor for deep vein thrombosis, making them a standard preventive measure post-hip arthroplasty.
Choice E reason: Anticoagulants (e.g., heparin) inhibit clot formation by interfering with the coagulation cascade, reducing the risk of thromboembolism. They are critical post-hip arthroplasty, as surgery increases clotting risk due to endothelial damage and immobility.

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Correct Answer is A

Explanation

Choice A reason: The wearing-off phenomenon in Parkinson’s occurs when levodopa’s effect diminishes before the next dose, causing symptom fluctuations. This results from progressive dopamine neuron loss, reducing storage capacity, and shorter levodopa half-life, leading to rapid swings in motor control as plasma levels fluctuate.
Choice B reason: Intolerance to medications may cause side effects (e.g., nausea), but the wearing-off phenomenon is due to disease progression and levodopa’s pharmacokinetics, not patient tolerance. Symptoms return as drug levels drop, not because of inability to tolerate the dose.
Choice C reason: Medications like levodopa remain effective, but wearing-off occurs due to shorter duration of action as Parkinson’s progresses, not loss of drug efficacy. Neuron loss reduces dopamine storage, causing symptoms to re-emerge between doses, not a failure of the drug itself.
Choice D reason: The liver metabolizes levodopa minimally; carbidopa prevents peripheral breakdown. Wearing-off is due to central nervous system changes (loss of dopamine neurons), not liver dysfunction, which does not significantly alter levodopa’s pharmacokinetics in Parkinson’s disease.

A. Assess neurovascular status in both legs. B. Elevate the surgical leg and apply ice. C. Prepare to administer pain medication. D. Try to place the surgical leg in abduction.

Correct Answer is A

Explanation

Choice A reason: A visibly shorter leg and extreme pain post-hip arthroplasty suggest possible hip dislocation, a serious complication. Assessing neurovascular status (pulse, sensation, movement, color, temperature) in both legs is critical to detect compromised blood flow or nerve damage, which could lead to tissue ischemia or permanent injury if not addressed promptly.
Choice B reason: Elevating the leg and applying ice may reduce swelling but does not address the potential dislocation indicated by leg shortening and pain. These interventions could delay critical assessment and management of neurovascular compromise, potentially worsening outcomes in a suspected dislocation scenario.
Choice C reason: Administering pain medication may alleviate discomfort but does not address the underlying cause, such as a dislocated hip prosthesis. Pain relief is secondary to ensuring neurovascular integrity and confirming the surgical leg’s alignment, which are critical to prevent complications like tissue necrosis.
Choice D reason: Attempting to place the leg in abduction without confirming the cause of shortening and pain risks further damage, especially if the hip is dislocated. Manipulation could exacerbate neurovascular compromise or prosthesis misalignment, leading to prolonged recovery or additional surgical intervention.

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A nurse is planning postoperative care for a client following a total hip arthroplasty. What nursing interventions would help prevent venous thromboembolism for this client? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When treating patients with medications for Parkinson’s disease, the nurse knows that the wearing-off phenomenon occurs for which reason?

Correct Answer is A

Explanation

The nurse assesses a client after a total hip arthroplasty. The client’s surgical leg is visibly shorter than the other one and the client reports extreme pain. While a co-worker calls the surgeon, what action by the nurse is appropriate?

Correct Answer is A

Explanation

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