A nurse is caring for a client who is postoperative and is at risk for developing venous thromboembolism (VTE). The nurse should instruct the client to avoid which of the following unsafe actions?
Ambulating soon after surgery
Flexing her ankles
Massaging her legs
Elevating her feet
The Correct Answer is C
A) Ambulating soon after surgery: Early ambulation is encouraged for postoperative clients to promote circulation and reduce the risk of venous thromboembolism (VTE). Mobilizing helps prevent stasis of blood in the veins, making this an appropriate action rather than an unsafe one.
B) Flexing her ankles: Ankle flexion exercises can help improve venous return and circulation in the lower extremities. This action is generally recommended to prevent VTE, making it a safe and beneficial practice for postoperative clients.
C) Massaging her legs: Massaging the legs is considered unsafe for a client at risk for VTE. This action can dislodge a thrombus (blood clot) if one is present, leading to potential complications such as pulmonary embolism. Therefore, the nurse should instruct the client to avoid leg massages.
D) Elevating her feet: Elevating the feet is a recommended practice to promote venous return and reduce swelling in postoperative clients. This action can help prevent VTE and is generally considered safe and beneficial.
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Correct Answer is ["A","C","D"]
Explanation
A) Furosemide: This is a loop diuretic that can lead to dehydration and electrolyte imbalances, both of which can contribute to orthostatic hypotension. The medication's diuretic effect can cause a significant drop in blood volume, increasing the risk of low blood pressure upon standing.
B) Simvastatin: This medication is used to lower cholesterol levels and is not associated with orthostatic hypotension. It does not have a direct impact on blood pressure or volume.
C) Losartan: As an angiotensin II receptor blocker (ARB), losartan is used to treat hypertension. It can cause vasodilation and may lead to orthostatic hypotension, particularly in elderly clients or those who are volume-depleted.
D) Nifedipine: This calcium channel blocker is used to treat hypertension and can cause vasodilation. It may lead to orthostatic hypotension as well, especially during dose adjustments or if the client is dehydrated.
E) Clopidogrel: This antiplatelet medication is used to prevent blood clots and does not directly cause orthostatic hypotension. Its primary action is to inhibit platelet aggregation, not to affect blood pressure.
Correct Answer is ["B","C","E","G"]
Explanation
A) Family history: Family history is a significant non-modifiable risk factor for atherosclerosis. While individuals cannot change their genetic predisposition, awareness of family history can inform lifestyle choices and risk assessments. Those with a family history should be particularly vigilant about managing other risk factors.
B) High blood pressure: High blood pressure is a modifiable risk factor that can be controlled through lifestyle changes such as diet, exercise, and medication if necessary. Effective management of hypertension can significantly reduce the risk of atherosclerosis and related cardiovascular diseases.
C) Obesity: Obesity is another modifiable risk factor. Individuals can manage their weight through healthy eating, physical activity, and lifestyle modifications. Reducing obesity can improve overall cardiovascular health and decrease the risk of developing atherosclerosis.
D) Age: Age is a non-modifiable risk factor. As people age, the risk for atherosclerosis naturally increases due to various biological changes. While aging itself cannot be altered, awareness of age-related risks can prompt individuals to adopt healthier lifestyles.
E) Lack of physical activity: This is a modifiable risk factor. Increasing physical activity can improve cardiovascular health and reduce the likelihood of developing atherosclerosis. Regular exercise can help maintain a healthy weight and improve blood pressure and cholesterol levels, contributing to overall heart health.
F) Gender: Gender is also a non-modifiable risk factor. While certain genders may have different risks at various life stages (e.g., men often have a higher risk at a younger age), this characteristic cannot be changed. Understanding gender-related risks can aid in tailoring preventive strategies but does not offer a means of modification.
G) Smoking: Smoking is a critical modifiable risk factor for atherosclerosis. Quitting smoking can significantly lower the risk of cardiovascular diseases and improve overall health. Smoking cessation should be a priority for individuals looking to prevent or manage atherosclerosis effectively.