Compression Devices And DVT Prevention - NCLEX Pn

1. What is the correct technique to apply TED hose to minimize tourniquet effect?

   Do not roll down or fold; ensure top band is not constricting. Avoiding folds prevents localized constriction that could impair circulation or cause skin injury.

2. What is the major contraindication to SCDs or TED hose on the affected limb?

   Known or suspected acute DVT in that limb. Compression on an existing clot may cause it to break loose, leading to pulmonary embolism or other complications.

3. Identify the most important initial nursing action before applying TED hose or SCDs.

   Assess legs: skin integrity, pulses, sensation, edema, and pain. Baseline assessment ensures no contraindications like poor circulation or skin issues that could worsen with compression.

4. Which action is required when a patient with SCDs gets out of bed to ambulate?

   Remove sleeves for ambulation, then reapply and restart pump in bed. Removing during activity prevents tripping hazards, and reapplying ensures continued prophylaxis when immobile.

5. Which medication class is commonly combined with mechanical compression for DVT prophylaxis?

   Anticoagulants such as low-molecular-weight heparin or heparin. Pharmacologic agents provide chemical prophylaxis, synergizing with mechanical methods for comprehensive DVT prevention.

6. Which patient statement indicates correct understanding of DVT prevention with SCDs?

   "I should wear them whenever I am in bed or sitting for long periods." Consistent use during immobility periods maximizes the device's role in reducing venous stasis and DVT risk.

7. What is the key difference between TED hose and SCDs for DVT prevention?

   TED hose provide continuous pressure; SCDs provide intermittent pressure. Continuous pressure offers steady support, while intermittent pressure actively pumps blood upward to mimic natural flow.

8. What is the correct timing for applying TED hose or SCDs to a high-risk immobile patient?

   Apply as early as possible and keep on whenever the patient is in bed. Early and consistent use maximizes prophylaxis against venous stasis during periods of highest immobility risk.

9. Which patient is at highest risk for DVT and most likely to require compression devices?

   Postoperative patient with limited mobility and additional risk factors. Surgery and immobility with comorbidities elevate venous stasis and hypercoagulability, heightening DVT likelihood.

10. A patient has SCDs ordered but is diaphoretic and has damp sleeves. What is the best action?

    Remove, dry skin, replace with clean dry sleeves, then restart pump. Moisture can cause skin maceration, so ensuring dryness maintains integrity and device effectiveness.

11. Identify the best nursing intervention to pair with compression devices for DVT prevention.

    Early ambulation and active leg exercises as tolerated. Combining mechanical methods with mobility enhances overall venous return and reduces stasis more effectively.

12. Identify the correct placement for SCD sleeves to prevent skin injury and ensure effectiveness.

    Smooth, wrinkle-free fit with tubing not kinked and heel/ankle aligned. Proper alignment and fit ensure even pressure distribution, optimizing efficacy while minimizing pressure points.

13. Which finding requires holding compression therapy and notifying the nurse or provider immediately?

    Suspected acute DVT: unilateral calf swelling, warmth, redness, pain. These signs indicate possible clot presence, where compression risks dislodging it and causing embolism.

14. Which patient situation is the most common indication for applying SCDs?

    Reduced mobility such as postoperative bed rest or prolonged immobility. Immobility causes venous stasis, increasing DVT risk, which compression devices counteract by promoting blood flow.

15. What is the primary purpose of compression devices (TED hose or SCDs) in hospitalized patients?

    Prevent venous stasis and reduce risk of deep vein thrombosis (DVT). These devices promote venous blood flow in immobilized patients, minimizing the pooling that leads to clot formation.

16. Which measurement is essential to select the correct TED hose size?

    Measure calf circumference and leg length per manufacturer guidelines. Accurate sizing based on measurements ensures optimal fit and pressure gradient for effective venous support.

17. What arterial condition is a contraindication to applying compression stockings?

    Severe peripheral arterial disease or impaired arterial circulation. Impaired arterial flow can be further compromised by compression, risking ischemia or tissue damage.

18. Which assessment finding suggests compression stockings may be unsafe due to poor arterial flow?

    Cool, pale extremity with weak or absent pedal pulses. These signs indicate arterial insufficiency, where compression could exacerbate reduced blood supply to tissues.

19. A patient reports numbness and tingling after TED hose application. What should you do first?

    Remove stockings and reassess circulation, sensation, and skin. Immediate removal and reassessment detect potential complications like nerve compression or impaired circulation.

20. Which mechanism best explains how sequential compression devices (SCDs) help prevent DVT?

    Intermittently compress legs to increase venous return and reduce stasis. Intermittent compression mimics muscle contractions, enhancing circulation and preventing blood pooling in veins.

21. Which nursing action best prevents pressure injury when a patient is wearing TED hose?

    Remove at least once per shift to assess skin and provide hygiene. Regular removal allows inspection for early signs of breakdown, ensuring skin integrity under constant pressure.

22. Which finding suggests SCD sleeves are too tight and require adjustment?

    New pain, discoloration, coolness, or decreased distal pulses. These symptoms indicate excessive pressure impairing circulation or nerve function, necessitating prompt adjustment.

23. What is the correct nursing action if SCD sleeves are on but the pump is turned off?

    Turn the pump on; sleeves alone do not provide effective prophylaxis. The pump provides the intermittent compression necessary for effective venous return, unlike static sleeves.

24. What is the correct nursing action when applying SCDs to a patient with fragile skin?

    Use protective barrier as ordered and inspect skin frequently. Barriers and monitoring protect vulnerable skin from friction or pressure injuries caused by the devices.

25. What is the priority patient teaching point about preventing DVT while using compression devices?

    Report unilateral leg pain/swelling and do not remove devices without guidance. Educating on DVT symptoms ensures early detection, while guidance prevents improper device handling.

Study these flashcards