Fundamentals of Nursing Q 478
Nurse Justin is taking care of a client with deep vein thrombosis. Which position should be provided to the client?
A. Bed rest with the affected extremity remains flat at all times.
B. Bed rest with the unaffected extremity on top of the affected extremity.
C. Bed rest with the affected extremity in a dependent position.
D. Bed rest with the affected extremity elevated.
Correct Answer: D. Bed rest with the affected extremity elevated.
Bed rest is indicated to prevent emboli while the elevation of the affected leg facilitates blood flow by the force of gravity and reduces pain and edema. Elevating the legs can help to instantly relieve pain. A doctor may also instruct a patient to elevate the legs above the heart three or four times a day for about 15 minutes at a time. This can help to reduce swelling. If prolonged standing or sitting is necessary, bending the legs several times will help promote blood circulation.
Option A: DVT develops as a result of being in a continuous seated prone positioning for 6 hours. Deep vein thrombosis and its sequelae such as PE can be severe or fatal. However, these consequences are preventable. Deep vein thrombosis may arise spontaneously or may be caused by trauma, surgery, or prolonged bed rest.
Option B: Deep vein thrombosis is a clinical challenge for doctors because it can develop in any section of the venous system; however, it arises most frequently in the deep veins of the leg. There are reports of DVT developing in a fiberglass mold maker after 6 weeks of working in a kneeling position, and in a patient maintaining a prone position after spine surgery with a central venous catheter in place.
Option C: A surgical operation where the patient is asleep (under general anesthetic) is the most common cause of a DVT. The legs are still when the client is under anesthetic because the muscles in the body are temporarily paralyzed. Blood flow in the leg veins can become very slow, making a clot more likely to occur. Certain types of surgery (particularly operations on the pelvis or legs) increase the risk of DVT even more.