A postoperative client is at risk for deep vein thrombosis (DVT). Which intervention helps prevent DVT?

DVT prevention is a major postoperative concern. Virchow's triad of DVT risk: venous stasis, endothelial injury, hypercoagulability — all increased after surgery. Prevention strategies: (1) Early ambulation — get clients up walking as soon as safely possible, even on postoperative day 0; (2) Sequential compression devices (SCDs) — pneumatic sleeves on legs that intermittently compress to promote venous return — used continuously when client is in bed; (3) Pharmacologic prophylaxis — typically low-molecular-weight heparin (enoxaparin) or unfractionated heparin in lower doses, per orders; (4) Range-of-motion exercises and ankle pumps when in bed; (5) Adequate hydration; (6) Avoid prolonged sitting with legs dependent; (7) Anti-embolism stockings (TED hose) — provide gradient compression.

Do not: massage the calves (can dislodge a clot); cross legs at the knees (impairs venous return); pillow under the knees (impairs venous return). Signs of DVT: unilateral leg swelling, warmth, erythema, calf pain, sometimes Homan's sign (no longer reliable).