To prevent thrombophlebitis after cesarean delivery, mother is advised for - - RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Obstetrics & Gynaecology

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2024

Explanation

Early and frequent ambulation is the most effective non-pharmacological method to prevent venous stasis, a primary cause of thrombophlebitis.
Walking activates the calf muscle pump, which actively propels blood from the veins in the lower extremities back to the heart.
This action prevents blood from pooling in the leg veins, significantly reducing the risk of clot formation.
Post-cesarean patients are at an increased risk for venous thromboembolism (VTE), making early mobilization a critical nursing priority.

Option B: Applying warm moist packs is a therapeutic intervention used to manage the symptoms of existing superficial thrombophlebitis, such as pain and inflammation.
Option C: Remaining on bed rest is contraindicated as it is a major risk factor for developing thrombophlebitis. Immobility leads to venous stasis, which is the primary condition that prevention aims to avoid.
Option D: While leg elevation helps promote venous return through gravity, it is a passive measure. It is less effective than the active muscle contraction provided by ambulation.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of postoperative venous thromboembolism (VTE) / thrombophlebitis after cesarean delivery as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating and encouraging postpartum mothers to ambulate early and frequently to prevent life-threatening complications like pulmonary embolism (PE), which can result from a DVT.
The risk for VTE is nearly doubled for women who have a cesarean delivery compared to a vaginal birth, making preventive nursing actions like promoting ambulation a critical patient safety measure.
What if the patient cannot ambulate due to a complication like a severe spinal headache or excessive pain? In this scenario, the nurse's priority shifts to implementing other preventive measures, such as teaching the patient to perform in-bed leg exercises (ankle pumps, leg flexion) and ensuring the correct application and consistent use of sequential compression devices (SCDs) until ambulation is possible.

How to Approach the Question

First, identify the key clinical goal in the question stem: 'to prevent thrombophlebitis'.
Next, note the patient context: 'after cesarean delivery', which is a high-risk period for blood clots.
Evaluate each option by asking: 'Is this a preventive measure, a treatment for an existing condition, or a risk factor?'
Recognize that 'Ambulate frequently' is an active, primary preventive strategy.
Identify 'Apply warm moist packs' and 'Elevate the legs' as interventions primarily for managing an existing condition, not for initial prevention in a healthy postpartum patient.
Eliminate 'Remain on bed rest' as it is a direct cause and risk factor for thrombophlebitis.

Concept Tested & Keywords

Concept Tested: Prevention of postoperative venous thromboembolism (VTE) / thrombophlebitis after cesarean delivery.
Stem keywords: prevent, thrombophlebitis, cesarean delivery
Lead-in keywords: advised for
Negative lead-in flag: false

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