NCLEX · Physiological Adaptation

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

Correct answer

Early ambulation, sequential compression devices (SCDs), prophylactic anticoagulation as ordered, leg exercises while in bed

  1. A Strict bed rest
  2. B Early ambulation, sequential compression devices (SCDs), prophylactic anticoagulation as ordered, leg exercises while in bed
  3. C Massaging the calves daily
  4. D Crossing the legs at the knees

Why this is the answer

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).
Source: NCLEX-RN, Physiological Adaptation — DVT Prevention