This question tests understanding of DVT prevention and ensuring proper SCD application in obese residents with limited mobility. The priority concern is that loosely fitted SCDs provide inadequate compression for DVT prevention. Rewrapping sleeves for snug fit and confirming pump function at ordered settings (Option A) ensures the device provides therapeutic compression. Option B (powder application with loose fit) maintains ineffective compression; Option C (switching to stockings) requires physician order and may be less effective for this patient; Option D (pillow under knees) could impede venous return and doesn't address the loose fit. The decision-making principle is that SCDs must maintain proper fit throughout use to provide effective intermittent pneumatic compression. A transferable strategy is to check SCD placement and fit at regular intervals, especially in patients with obesity where sleeves may slide more easily, and readjust as needed.

This question tests understanding of DVT prevention and proper compression device application to prevent skin complications. The priority concern is addressing improper device layering that has caused skin irritation at pressure points. Removing devices, assessing skin and circulation, reapplying SCDs correctly per policy, and reporting skin redness (Option C) ensures safe compression therapy while addressing the complication. Option A (leaving both devices) continues harmful pressure; Option B (keeping only stockings) may provide inadequate compression; Option D (topical antibiotic) doesn't address the mechanical cause. The decision-making principle is that compression devices should never be layered as this creates excessive pressure and skin breakdown risk. A transferable strategy is to ensure only one type of compression device is used at a time, following facility protocols for device selection based on patient mobility and risk factors.

This question tests understanding of DVT prevention and appropriate response to concerning findings in a post-operative knee replacement patient. The priority concern is recognizing potential DVT development in the operative leg with increased edema and asymmetric calf measurements. Removing the stocking to assess for pain, warmth, color changes, and pulses while reporting increased swelling to the RN (Option B) ensures proper evaluation of potential complications. Option A (rolling stocking tightly) could compromise circulation; Option C (massaging the calf) is contraindicated if DVT is suspected as it could dislodge a clot; Option D (keeping stocking off) removes necessary compression therapy. The decision-making principle is that new or worsening unilateral leg swelling post-operatively requires immediate assessment to rule out DVT. A transferable strategy is to perform comprehensive leg assessments before compression device application and when any changes occur, documenting and reporting concerning findings promptly.

This question tests understanding of DVT prevention and use of compression devices. The priority concern is new unilateral calf redness, tenderness, and enlargement, suggesting possible DVT, requiring immediate cessation of compression on the affected leg to avoid clot dislodgement. Stopping SCD use on the affected leg and reporting promptly allows for safe evaluation and management. Encouraging ankle circles or massaging risks embolization; applying warmth could worsen inflammation. The decision-making principle in compression therapy is to discontinue use on symptomatic legs and escalate for suspected thrombosis. This prevents complications like pulmonary embolism. A transferable strategy is to halt compression and notify providers upon detecting unilateral symptoms, followed by monitoring vital signs to ensure timely DVT intervention.

This question tests understanding of DVT prevention and recognition of effective compression device function. The priority concern is confirming that SCDs are providing appropriate intermittent pneumatic compression. Regular inflation and deflation cycles while the resident is in bed (Option A) indicates proper device function and effective DVT prophylaxis. Option B (elevated blood pressure) is unrelated to SCD effectiveness; Option C (tight feeling/non-use) indicates poor compliance; Option D (calf massage) is inappropriate and potentially dangerous if clots are present. The decision-making principle is that effective compression therapy requires consistent device function with regular compression cycles. A transferable strategy is to observe complete SCD cycles during assessments, document proper function, and address any patient concerns about comfort to ensure continuous use.

This question tests understanding of DVT prevention and recognition of acute DVT symptoms in post-operative patients using compression stockings. The priority concern is identifying signs of possible DVT development despite prophylactic measures. New calf pain with increased circumference since morning (Option A) indicates potential DVT formation requiring immediate RN notification. Option B (extra blanket request) is a comfort measure; Option C (damp stocking) is expected with wear; Option D (food preferences) is unrelated to DVT risk. The decision-making principle is that new onset calf pain with measurable swelling progression requires immediate evaluation for possible DVT. A transferable strategy is to establish baseline measurements post-operatively and monitor for changes in circumference, especially when accompanied by new pain, warmth, or redness.

This question tests understanding of DVT prevention and proper use of sequential compression devices (SCDs) in long-term care residents with limited mobility. The priority concern is ensuring the SCD is functioning properly to provide effective DVT prophylaxis. Verifying correct sleeve size, proper fit (snug without constriction), and confirming the pump is cycling as ordered (Option B) ensures optimal compression therapy effectiveness. Option A (removing sleeves for sleep) defeats the purpose of continuous DVT prevention; Option C (heparin infusion) requires a physician order and is not within LPN scope; Option D (measuring I&O) relates to fluid balance but doesn't directly ensure SCD effectiveness. The decision-making principle is that mechanical compression devices must fit properly and function continuously to prevent venous stasis. A transferable strategy is to check SCD fit and function at every assessment, ensuring sleeves are properly sized, positioned, and the pump is cycling appropriately.

This question tests understanding of DVT prevention and use of compression devices. The priority concern is identifying potential postoperative DVT indicated by increased calf circumference and edema in the operative leg, which requires escalation for evaluation. Reporting the increased calf circumference and swelling to the RN ensures optimal assessment and possible intervention to rule out thrombosis. Massaging the calf could dislodge a clot; reapplying loosely reduces compression effectiveness; encouraging fluids and rechecking later delays necessary action. The decision-making principle in compression therapy is to prioritize reporting signs of complications like unilateral swelling over independent adjustments to the device. This approach prevents progression to serious events like embolism. A transferable strategy is to document baseline and ongoing measurements of leg circumferences and edema, reporting changes promptly to maintain effective DVT prevention.

This question tests understanding of DVT prevention and use of compression devices. The priority concern is detecting early signs of DVT, such as new unilateral calf pain and increased circumference, which necessitate reporting to prevent escalation. Reporting the client's new unilateral calf pain with increased circumference compared to the other leg alerts the RN for further assessment and intervention. Requesting an extra blanket is unrelated; clean, wrinkle-free stockings are expected; fatigue after therapy is normal and not critical. The decision-making principle in compression therapy is to prioritize reporting symptoms suggestive of thrombosis over routine observations. This ensures timely management in postoperative clients. A transferable strategy is to assess and compare pain levels and calf measurements bilaterally during each shift, reporting variances to maintain effective monitoring for DVT.

This question tests understanding of DVT prevention and use of compression devices. The priority concern is incorrect application of compression stockings, such as rolling down, which creates a tourniquet effect and impairs circulation in a postoperative client. Teaching the caregiver to avoid rolling and smooth them flat prevents tight bands, ensuring optimal graduated compression to enhance venous return. Applying only when swelling is present is inconsistent; doubling stockings increases pressure unevenly; requesting pain medication does not address application errors. The decision-making principle in compression therapy is to educate on proper donning techniques to avoid constriction and maintain even pressure. This promotes effective DVT prevention without causing harm. A transferable strategy is to demonstrate and have caregivers return-demonstrate stocking application, reassessing fit regularly to ensure ongoing effectiveness.