When assessing a postoperative client, a nurse finds that there ...

[bcretired]

When assessing a postoperative client, a nurse finds that there is tenderness, redness, and swelling in the left calf. The nurse should:
 
  A. Massage the lower leg
  B. Prepare for heparin therapy
  C. Keep the leg in a dependent position
  D. Have the client exercise that extremity

Question 2

A nurse classifies a pressure ulcer based on the color of the wound bed. A red wound has:
 
  A. Necrotic tissue
  B. Significant exudate
  C. Excessive bleeding
  D. Granulation tissue

[trampas]

Answer to Question 1

B
B. Client complains of calf tenderness; redness, and edema in lower extremity. These are signs and symptoms of venous thrombosis or thrombophlebitis. Notify physician, and anticipate orders for bed rest, leg elevation, and initiation of anticoagulation (e.g., heparin intravenous drip).
A. Do not massage affected leg.
C. Anticipate orders for bed rest, leg elevation, and initiation of anticoagulation (e.g., heparin intravenous drip).
D. Continue to have client do leg exercises with unaffected leg.

Answer to Question 2

D
A, B, C, and D. Red tissue is granulation tissue.

[bcretired]

Both answers were spot on, thank you once again

[trampas]

Great! Please up vote