Which complication can be prevented by early ambulation during the postoperative period?

Appeared in: Haryana CHO - 2022

Explanation

Early ambulation is a primary method to prevent venous thromboembolism (VTE), which includes Deep Vein Thrombosis (DVT).
Immobility following surgery leads to venous stasis (pooling of blood) in the lower extremities, a major risk factor for clot formation.
Walking activates the calf muscle pump, which contracts the leg muscles, compresses the deep veins, and propels blood back to the heart.
This mechanical action directly counteracts venous stasis, significantly reducing the risk of a thrombus developing.

Option A: Early ambulation may initially increase incisional pain. Pain is an expected postoperative symptom, not a complication prevented by walking.
Option C: Postoperative vomiting is primarily caused by the side effects of anesthesia, opioid analgesics, or delayed gastric emptying.
Option D: Surgical site infections are caused by microbial contamination of the wound. Ambulation has no direct effect on preventing this.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of postoperative complications as background academic context rather than a clinical decision trigger.
A nurse's primary role in DVT prevention is to encourage and assist with early and frequent ambulation as per the surgeon's orders.
Patient education is crucial. The nurse must explain that despite some discomfort, walking is essential to prevent a potentially life-threatening blood clot.
What if? If a patient is unable to ambulate due to their surgical procedure or condition (e.g., spinal anesthesia, extensive surgery), the nurse must prioritize other preventive measures like in-bed leg exercises, applying sequential compression devices (SCDs), and ensuring prescribed anticoagulant medication is administered.

How to Approach the Question

First, identify the core nursing intervention in the question: 'early ambulation' in the 'postoperative period'.
Think about the primary physiological effect of walking after a period of immobility. The key effect is the stimulation of circulation in the lower extremities.
Next, evaluate each option to determine which complication is directly related to poor circulation or blood stasis.
Pain is related to tissue trauma from surgery. Vomiting is related to anesthesia/meds. Infection is related to microbial contamination.
Deep Vein Thrombosis (DVT) is directly caused by venous stasis. Therefore, an intervention that improves circulation will prevent DVT.
Conclude that early ambulation's main prophylactic benefit among the choices is preventing DVT.

Concept Tested & Keywords

QmkFC5uVp2pnGgDtllRrSL

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 1 pp. 125-127, 121-123

Practise the full Haryana CHO - 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.