Postoperative Complications (DVT/PE Prevention) - NCLEX-RN
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Which postoperative assessment best verifies that SCDs are being used effectively?
Which postoperative assessment best verifies that SCDs are being used effectively?
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Sleeves are on while in bed and the pump is cycling/compressing. Confirms proper device function and patient compliance during periods of immobility to maintain prophylaxis.
Sleeves are on while in bed and the pump is cycling/compressing. Confirms proper device function and patient compliance during periods of immobility to maintain prophylaxis.
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Which postoperative action best prevents venous stasis in a patient on bed rest?
Which postoperative action best prevents venous stasis in a patient on bed rest?
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Perform leg exercises (ankle pumps/ROM) regularly. Active range of motion exercises enhance circulation and prevent venous pooling in immobilized patients.
Perform leg exercises (ankle pumps/ROM) regularly. Active range of motion exercises enhance circulation and prevent venous pooling in immobilized patients.
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What is the correct positioning intervention to reduce venous stasis after surgery?
What is the correct positioning intervention to reduce venous stasis after surgery?
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Elevate legs and avoid knee flexion or leg crossing. Elevation facilitates venous drainage while avoiding positions that compress veins, minimizing stasis risk.
Elevate legs and avoid knee flexion or leg crossing. Elevation facilitates venous drainage while avoiding positions that compress veins, minimizing stasis risk.
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Which device provides intermittent pneumatic compression to prevent postoperative DVT?
Which device provides intermittent pneumatic compression to prevent postoperative DVT?
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Sequential compression device (SCD). Intermittent compression mimics muscle contractions to promote venous flow and prevent clot formation.
Sequential compression device (SCD). Intermittent compression mimics muscle contractions to promote venous flow and prevent clot formation.
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What is the priority nursing check before applying SCDs postoperatively?
What is the priority nursing check before applying SCDs postoperatively?
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Assess skin integrity and peripheral circulation. Ensures no contraindications like skin breakdown or impaired circulation that could worsen with compression.
Assess skin integrity and peripheral circulation. Ensures no contraindications like skin breakdown or impaired circulation that could worsen with compression.
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Which instruction is correct when a patient with SCDs gets out of bed to ambulate?
Which instruction is correct when a patient with SCDs gets out of bed to ambulate?
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Remove SCD sleeves for ambulation and reapply afterward. Allows safe mobility while ensuring continued prophylaxis when the patient returns to bed rest.
Remove SCD sleeves for ambulation and reapply afterward. Allows safe mobility while ensuring continued prophylaxis when the patient returns to bed rest.
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What is the correct use rule for antiembolism stockings (TED hose) postoperatively?
What is the correct use rule for antiembolism stockings (TED hose) postoperatively?
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Apply smoothly, remove daily to inspect skin, then reapply. Smooth application prevents constriction, and daily inspection detects skin issues early.
Apply smoothly, remove daily to inspect skin, then reapply. Smooth application prevents constriction, and daily inspection detects skin issues early.
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Which finding suggests antiembolism stockings are too tight and need adjustment?
Which finding suggests antiembolism stockings are too tight and need adjustment?
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Numbness/tingling, cool toes, or diminished distal pulses. These signs indicate compromised circulation due to excessive compression, requiring immediate adjustment to prevent tissue damage.
Numbness/tingling, cool toes, or diminished distal pulses. These signs indicate compromised circulation due to excessive compression, requiring immediate adjustment to prevent tissue damage.
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What is the most common initial clinical sign of postoperative DVT in an extremity?
What is the most common initial clinical sign of postoperative DVT in an extremity?
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Unilateral calf or leg swelling. Asymmetric swelling reflects venous obstruction from a thrombus in the affected limb.
Unilateral calf or leg swelling. Asymmetric swelling reflects venous obstruction from a thrombus in the affected limb.
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Which symptom pattern most strongly suggests DVT rather than normal postop soreness?
Which symptom pattern most strongly suggests DVT rather than normal postop soreness?
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Unilateral calf pain/tenderness with warmth and erythema. Localized inflammation and pain differentiate DVT from bilateral postoperative muscle strain.
Unilateral calf pain/tenderness with warmth and erythema. Localized inflammation and pain differentiate DVT from bilateral postoperative muscle strain.
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What is the priority nursing action if DVT is suspected in a postoperative patient?
What is the priority nursing action if DVT is suspected in a postoperative patient?
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Stop ambulation and notify the provider immediately. Prevents potential embolization of the clot while alerting the provider for diagnostic confirmation.
Stop ambulation and notify the provider immediately. Prevents potential embolization of the clot while alerting the provider for diagnostic confirmation.
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Which action should the nurse avoid when DVT is suspected postoperatively?
Which action should the nurse avoid when DVT is suspected postoperatively?
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Do not massage the calf or affected extremity. Massage could dislodge the clot, leading to pulmonary embolism.
Do not massage the calf or affected extremity. Massage could dislodge the clot, leading to pulmonary embolism.
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Which assessment finding is most consistent with acute pulmonary embolism (PE)?
Which assessment finding is most consistent with acute pulmonary embolism (PE)?
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Sudden dyspnea with tachycardia and pleuritic chest pain. These symptoms result from sudden pulmonary artery occlusion, impairing gas exchange and cardiac output.
Sudden dyspnea with tachycardia and pleuritic chest pain. These symptoms result from sudden pulmonary artery occlusion, impairing gas exchange and cardiac output.
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What is the priority nursing intervention when PE is suspected after surgery?
What is the priority nursing intervention when PE is suspected after surgery?
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Apply oxygen and call rapid response/activate emergency system. Addresses hypoxia and stabilizes the patient while summoning expert assistance for potential deterioration.
Apply oxygen and call rapid response/activate emergency system. Addresses hypoxia and stabilizes the patient while summoning expert assistance for potential deterioration.
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Which patient position is most appropriate while managing suspected PE?
Which patient position is most appropriate while managing suspected PE?
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High Fowler position (upright) if tolerated. Upright positioning reduces respiratory effort and improves ventilation-perfusion matching in acute respiratory distress.
High Fowler position (upright) if tolerated. Upright positioning reduces respiratory effort and improves ventilation-perfusion matching in acute respiratory distress.
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Which postoperative medication class is commonly prescribed specifically for DVT prophylaxis?
Which postoperative medication class is commonly prescribed specifically for DVT prophylaxis?
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Anticoagulants (e.g., LMWH or unfractionated heparin). These agents inhibit clot formation by interfering with the coagulation cascade, targeting hypercoagulability in surgical patients.
Anticoagulants (e.g., LMWH or unfractionated heparin). These agents inhibit clot formation by interfering with the coagulation cascade, targeting hypercoagulability in surgical patients.
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What laboratory test is used to monitor IV unfractionated heparin therapy?
What laboratory test is used to monitor IV unfractionated heparin therapy?
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aPTT. Monitors therapeutic levels to ensure effective anticoagulation without excessive bleeding risk.
aPTT. Monitors therapeutic levels to ensure effective anticoagulation without excessive bleeding risk.
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What is the single most effective postoperative nursing intervention to prevent DVT?
What is the single most effective postoperative nursing intervention to prevent DVT?
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Early ambulation as soon as it is safe. Promotes venous return and reduces blood stasis in the lower extremities, a key factor in Virchow's triad for thrombosis prevention.
Early ambulation as soon as it is safe. Promotes venous return and reduces blood stasis in the lower extremities, a key factor in Virchow's triad for thrombosis prevention.
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Which surgery type is associated with particularly high postoperative DVT/PE risk?
Which surgery type is associated with particularly high postoperative DVT/PE risk?
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Hip or knee replacement (major orthopedic surgery). These procedures involve significant venous trauma and immobility, elevating thrombosis risk per evidence-based guidelines.
Hip or knee replacement (major orthopedic surgery). These procedures involve significant venous trauma and immobility, elevating thrombosis risk per evidence-based guidelines.
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Which nursing instruction best reduces DVT risk for a postoperative patient traveling home by car?
Which nursing instruction best reduces DVT risk for a postoperative patient traveling home by car?
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Stop often to walk and do ankle pumps during the trip. Frequent movement counteracts prolonged venous stasis associated with extended sitting during travel.
Stop often to walk and do ankle pumps during the trip. Frequent movement counteracts prolonged venous stasis associated with extended sitting during travel.
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Which patient statement indicates correct understanding of PE warning signs after discharge?
Which patient statement indicates correct understanding of PE warning signs after discharge?
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“I will seek urgent care for sudden shortness of breath or chest pain.”. Recognizing acute symptoms of PE enables prompt medical intervention to prevent fatal outcomes.
“I will seek urgent care for sudden shortness of breath or chest pain.”. Recognizing acute symptoms of PE enables prompt medical intervention to prevent fatal outcomes.
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What laboratory value is commonly monitored to evaluate warfarin therapy?
What laboratory value is commonly monitored to evaluate warfarin therapy?
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INR. Assesses the degree of anticoagulation by measuring prothrombin time, guiding dosage adjustments.
INR. Assesses the degree of anticoagulation by measuring prothrombin time, guiding dosage adjustments.
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Which medication is the antidote for unfractionated heparin-associated bleeding?
Which medication is the antidote for unfractionated heparin-associated bleeding?
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Protamine sulfate. Binds to heparin and neutralizes its anticoagulant effects rapidly in cases of overdose or hemorrhage.
Protamine sulfate. Binds to heparin and neutralizes its anticoagulant effects rapidly in cases of overdose or hemorrhage.
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Which medication is the antidote for warfarin-associated bleeding?
Which medication is the antidote for warfarin-associated bleeding?
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Vitamin K (phytonadione). Reverses warfarin's inhibition of vitamin K-dependent clotting factors, restoring coagulation.
Vitamin K (phytonadione). Reverses warfarin's inhibition of vitamin K-dependent clotting factors, restoring coagulation.
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Which postoperative patient factor most increases risk for DVT and requires aggressive prophylaxis?
Which postoperative patient factor most increases risk for DVT and requires aggressive prophylaxis?
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Immobility or prolonged bed rest. Stasis from inactivity is a primary component of Virchow's triad, necessitating interventions like compression or ambulation.
Immobility or prolonged bed rest. Stasis from inactivity is a primary component of Virchow's triad, necessitating interventions like compression or ambulation.
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