The nurse has been assigned to care for several postoperative ...

[JMatthes]

The nurse has been assigned to care for several postoperative patients. Which patient is most likely to develop thrombophlebitis?
 
  a. A patient status post outpatient cholecys-tectomy with a history of blood clots.
  b. A patient who is 6 days postoperative for total right hip replacement with a history of left-sided stroke.
  c. A patient who underwent major abdomin-al surgery and was dehydrated upon ad-mission.
  d. A patient who is 2 days postoperative for hernia repair with a history of diabetes.

Question 2

The nurse is assessing a female patient with a family history of coronary artery disease (CAD). Which report is most concerning to the nurse?
 
  a. I get a little short of breath after climbing the three flights of stairs to my apart-ment.
  b. I stay tired all of the time, and it feels like my bra is too tight.
  c. I awaken frequently in the night, and my husband says that I snore.
  d. I notice wheezing after I dust or when I exercise.

[fwbard]

Answer to Question 1

B
Although all of these patients are at varying degrees of risk for thrombophlebitis, the hip re-placement surgery places a patient at high risk for thrombophlebitis due to limited mobility, es-pecially after the fifth postoperative day. This patient is at even higher risk of thrombophlebitis because of a history of left-sided stroke.

Answer to Question 2

B
In addition to displaying a positive family history for CAD, report of fatigue and shoulder and back discomfort are most concerning to the nurse. Chest pain is often atypical in women and may manifest as pain in the shoulders, back, or abdomen. Mild shortness of breath after climbing three flights of stairs is consistent with exertion. Awakening frequently in the night and snoring are suspicious for obstructive sleep apnea. Wheezing in the presence of dust or with exercise are findings consistent with potential asthma.