Author Question: The nurse is aware that patients who are immobile are at increased risk of developing deep vein ... (Read 39 times)

yoroshambo · **on:** Jul 22, 2018

The nurse is aware that patients who are immobile are at increased risk of developing deep vein thromboses (DVTs). Because of this, the nurse should

a. Make sure that elastic stockings are not removed.
b. Measure the calf circumference of both legs.
c. Dorsiflex the foot while assessing for patient discomfort.
d. Measure both ankles to determine size.

Question 2

Communication skills are adapted by the nurse for pediatric clients. Which of the following communication techniques may be used most effectively with toddlers or preschoolers?

a. Using analogies to explain health-related ideas
b. Providing toys and distractions
c. Moving quickly and minimizing contact to avoid distress
d. Focusing on what other children have done

isabelt_18 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

B
Measure bilateral calf circumference and record it daily as an assessment for DVT. Homans' sign, or calf pain on dorsiflexion of the foot, is contraindicated in patients when a DVT is suspected. It is no longer a reliable indicator in assessing for DVT, and it is present in other conditions. Remove the patient's elastic stockings and/or sequential compression devices (SCDs) every 8 hours, and observe the calves for redness, warmth, and tenderness. Bilateral calf circumferences (not ankle) should be measured daily to detect unilateral increases that may be an early indication of thrombosis.

Answer to Question 2

B
Providing distractions or allowing toddlers and preschoolers the opportunity to play with toys allows parents to give their full attention to the nurse during an interview, and this is an effective communication technique.
Toddlers and preschoolers are unable to understand analogies.
Sudden movements can be frightening. Children often prefer to make the first move in interper-sonal contacts.
Focusing on what other children have done is not an effective communication technique for tod-dlers or preschoolers. Communication should be focused on the child.