SGPGI Nursing Officer-2023
Medical & Surgical Nursing
Easy
Purpose behind using the stocking following abdominal surgery?
Appeared in: SGPGI Nursing Officer-2023
Explanation
- The primary purpose of using anti-embolism stockings after surgery is to prevent Deep Vein Thrombosis (DVT).
- Surgery and subsequent immobility lead to venous stasis (pooling of blood) in the lower extremities, which is a major risk factor for clot formation.
- The stockings apply graduated pressure, highest at the ankle and decreasing up the leg, which enhances venous return to the heart.
- This mechanical compression increases the velocity of blood flow in the veins, preventing stasis and reducing the likelihood of a thrombus developing.
Why Other Options Were Wrong
- Option A: Atelectasis is a respiratory complication (collapsed lung alveoli). Stockings are applied to the legs and have no effect on lung function.
- Option C: Dehydration is a systemic fluid imbalance. Stockings are a mechanical device for the legs and do not influence the body's overall hydration status.
- Option D: Negative nitrogen balance is a metabolic state related to malnutrition where protein breakdown exceeds synthesis. Stockings have no impact on the patient's nutritional or metabolic state.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Post-operative complication prevention, specifically Venous Thromboembolism (VTE) prophylaxis as background academic context rather than a clinical decision trigger.
- VTE (DVT and PE) is a leading cause of preventable hospital-acquired death. Consistent use of prophylaxis, including compression stockings, is a critical nursing responsibility and a national patient safety goal.
- Nurses are responsible for correctly measuring, applying, and monitoring patients with compression stockings, including regular skin and neurovascular assessments to prevent complications like skin breakdown or nerve damage.
- What if? If the patient had diagnosed severe peripheral arterial disease (PAD), compression stockings would be contraindicated. The external pressure could further compromise already poor arterial blood flow, leading to ischemia.
How to Approach the Question
- First, identify the core subject of the question: the purpose of an intervention (stockings) in a specific context (post-abdominal surgery).
- Analyze the intervention shown in the image: these are medical compression stockings, not regular socks.
- Recall the major risks for a post-operative, immobile patient. These include respiratory (atelectasis), circulatory (DVT), fluid balance (dehydration), and nutritional (negative nitrogen balance) issues.
- Systematically evaluate each option. Connect the intervention (leg compression) to its direct physiological effect. Leg compression directly affects blood flow in the legs.
- Eliminate the options that are unrelated to the intervention's mechanism. Atelectasis is a lung issue, dehydration is a systemic fluid issue, and nitrogen balance is a nutritional issue. None are directly affected by leg stockings.
- Conclude that the only logical purpose is to affect leg circulation to prevent clots (DVT).
Concept Tested & Keywords
- Concept Tested: Post-operative complication prevention, specifically Venous Thromboembolism (VTE) prophylaxis.
- Stem keywords: stocking, abdominal surgery, post-operative care
- Lead-in keywords: Purpose
- Clinical cues: The use of a specific medical device (stockings) in a post-operative context points to a question about preventing common complications related to immobility.
Question ID
QNd7QsJGOGokMUBqW4rM7d
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 p. 125-127
E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 186-188
E6 Nursing Fundamentals Taylor p. 332-334
Practise the full SGPGI Nursing Officer-2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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