The nurse is teaching a postoperative client measures to reduce the risk of postoperative complications. Which teaching point would the nurse reinforce to decrease the risk of thrombophlebitis and phlebothrombosis?

Avoid crossing the legs.

Massage the calves and thigh.

Prop pillows under knees.

Encourage ambulation twice daily.

Answer and Explanation

The Correct Answer is A

A. Avoid crossing the legs: Crossing the legs can impede venous return by compressing the veins in the leg therefore increasing the risk of clot formation in the lower extremities. Teaching clients to keep legs uncrossed helps maintain proper circulation and reduces venous stasis postoperatively.
B. Massage the calves and thigh: Massaging the legs can dislodge an existing thrombus, leading to a potential pulmonary embolism. This practice is contraindicated in clients at risk for deep vein thrombosis (DVT).
C. Prop pillows under knees: Placing pillows under the knees promotes venous stasis by compressing the popliteal vein. This can increase the risk of thrombophlebitis and should be avoided in post-op care.
D. Encourage ambulation twice daily: Although ambulation is beneficial, twice daily may not be frequent enough to adequately promote circulation. More regular movement and leg exercises are typically recommended to prevent clot formation.

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Correct Answer is C

Explanation

A. History of thrombophlebitis in both extremities: This is a non-modifiable risk factor. Prior venous inflammation or clotting increases susceptibility to varicose veins but cannot be changed through lifestyle modifications.
B. Mother and maternal grandmother had varicose veins: Family history reflects genetic predisposition and is a non-modifiable factor. Inherited vein wall weakness increases risk but cannot be influenced by behavior.
C. Employed as an over-the-road truck driver: Prolonged sitting or standing restricts venous return and contributes to vein distension. This is modifiable through frequent leg movement, walking breaks, and use of compression stockings.
D. Weight gained during past pregnancies: Weight gain during previous pregnancies is a past event and no longer modifiable. Although pregnancy increases venous pressure, current lifestyle changes can't alter that history.

A. "I will drink at least 3 L of fluid per day." B. "I will stop taking my medication if I notice any side effects and then notify the doctor." C. "I will notify the doctor if I am not having a bowel movement daily." D. "I will notify the doctor if I have a fever or any other signs of infection."

Correct Answer is D

Explanation

A. "I will drink at least 3 L of fluid per day.": While staying hydrated is beneficial, fluid intake is not directly related to the side effects or safety concerns of azathioprine. Some medications can affect the kidneys, making hydration crucial, but it's not the primary concern related to immune suppression.
B. "I will stop taking my medication if I notice any side effects and then notify the doctor.": Abruptly discontinuing azathioprine without physician approval may worsen Crohn's disease or cause withdrawal issues. Medication changes should always be guided by the healthcare provider to ensure safety and continuity of care.
C. "I will notify the doctor if I am not having a bowel movement daily.": Constipation is not a primary concern with azathioprine therapy, and bowel patterns may vary with Crohn’s flares. Monitoring for signs of infection or bone marrow suppression is far more critical with this drug.
D. "I will notify the doctor if I have a fever or any other signs of infection.":
Azathioprine suppresses immune function, increasing the risk for potentially serious infections. Prompt reporting of fever allows for early intervention to prevent sepsis or other complications in immunocompromised individuals.

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The nurse is teaching a postoperative client measures to reduce the risk of postoperative complications. Which teaching point would the nurse reinforce to decrease the risk of thrombophlebitis and phlebothrombosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following factors would the nurse identify as a modifiable risk factor for the development of varicose veins?

Correct Answer is C

Explanation

A client is taking the immunosuppressant medication, azathioprine (Imuran), for the treatment of Crohn's disease. What statement made by the client demonstrates an understanding of the side effects of this medication?

Correct Answer is D

Explanation

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