# A postpartum client diagnosed with deep vein thrombosis (DVT) in the left leg is receiving anticoagulant therapy. Which nursing intervention is most important for this client? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=543183 > language: ko > subject: Maternal Newborn Health ## 문제 A postpartum client diagnosed with deep vein thrombosis (DVT) in the left leg is receiving anticoagulant therapy. Which nursing intervention is most important for this client? ## 보기 1. Encourage active range of motion exercises for the affected leg 2. Maintain bed rest with the affected leg elevated **✔ 정답** 3. Apply warm compresses to the affected area every 2 hours 4. Massage the affected leg to promote circulation **정답: 2** ## 해설 Bed rest with leg elevation is critical for DVT to prevent clot dislodgement and pulmonary embolism while promoting venous return. Other interventions like exercise, warm compresses, or massage are contraindicated as they may increase embolism risk. ## 심화 해설 Correct Answer: 2. Maintain bed rest with the affected leg elevated Explanation The priority nursing intervention for a postpartum client with an acute deep vein thrombosis (DVT) is to maintain bed rest and elevate the affected extremity. The primary clinical concern during the acute phase of a DVT is the prevention of a pulmonary embolism (PE), a life-threatening complication where a portion of the thrombus dislodges, travels through the venous system, and obstructs pulmonary arteries. Bed rest minimizes muscle contractions in the calf and thigh, which could mechanically dislodge the unstable clot. Simultaneously, elevating the leg above the level of the heart promotes venous return via gravity, which reduces venous stasis, decreases edema, and alleviates pain without creating turbulent flow that might mobilize the thrombus. The pharmacological management of this condition supports this conservative approach. As outlined in the review by Zhu et al., low-molecular-weight heparin (LMWH) is a cornerstone of venous thromboembolism (VTE) treatment, particularly in postpartum clients where oral anticoagulation may require careful transition management [2]. The goal of anticoagulation is not to dissolve the existing clot but to prevent its propagation and allow the body's fibrinolytic system to stabilize and gradually resolve the thrombus. During this period of pharmacological stabilization, physical manipulation of the vessel must be avoided to allow the medication to achieve its therapeutic effect without mechanical complication. The incorrect options are contraindicated because they increase the risk of embolization. Encouraging active range of motion exercises on the affected leg involves skeletal muscle contraction, which compresses deep veins and can dislodge a fresh, non-adherent thrombus. Applying warm compresses causes local vasodilation and may inadvertently increase blood flow velocity around the clot, theoretically raising the risk of dislodgement; while sometimes used later for chronic venous insufficiency, it is not the priority in the acute phase. Massaging the affected leg is strictly prohibited, as direct mechanical pressure on the deep venous system is a direct and forceful mechanism for causing a pulmonary embolism. These interventions directly conflict with the principle of clot stabilization that underpins both the medical and nursing management of acute DVT .References (research sources) - [2]Revisiting low-molecular-weight heparin for venous thromboembolism: from pharmacology to precision dosing and implementation.Research articleZhu S, Ni Q, He J. (2026) · DOI: 10.3389/fphar.2026.1824218 ## 임상 시나리오 Clinical Management of Acute DVT in the Postpartum Client The immediate goal for a postpartum client diagnosed with an acute deep vein thrombosis (DVT) is to prevent the life-threatening complication of a pulmonary embolism (PE). The cornerstone of initial management combines pharmacological therapy with specific physical nursing interventions to stabilize the thrombus. Priority Nursing Interventions - **Strict Bed Rest:** Limit the client's activity to minimize muscle contractions in the affected extremity. Skeletal muscle movement can mechanically dislodge the unstable clot, sending it into the pulmonary circulation. - **Elevation of the Affected Leg:** Position the leg above the level of the heart. This uses gravity to promote venous return, reduce edema, and decrease venous stasis without creating the turbulent blood flow that could mobilize the thrombus. - **Avoid Manipulation:** Never massage the affected leg. Palpation and massage are strictly contraindicated as they can directly dislodge the clot. Warm compresses, while not harmful, are not a priority intervention compared to rest and elevation. - **Administer Anticoagulation:** As ordered, typically with low-molecular-weight heparin (LMWH). The goal is to prevent clot propagation, not to dissolve the existing clot, allowing the body's natural fibrinolytic system to work. Ongoing Assessment and Safety - Monitor for signs of pulmonary embolism: sudden dyspnea, tachypnea, pleuritic chest pain, and hemoptysis. - Assess the affected leg regularly for changes in circumference, color, temperature, and pain level. - Observe for signs of bleeding due to anticoagulant therapy, including epistaxis, gum bleeding, hematuria, and excessive bruising. - Measure and apply graduated compression stockings to the unaffected leg as prescribed to prevent further thrombus formation. ## 핵심 개념 - **Deep Vein Thrombosis (DVT)** — A condition where a blood clot forms in a deep vein, most commonly in the legs, posing a risk of pulmonary embolism if the clot dislodges. - **Pulmonary Embolism (PE)** — A life-threatening complication of DVT where a thrombus travels to the lungs, blocking a pulmonary artery and impairing gas exchange. - **Anticoagulation Therapy** — Pharmacological treatment using agents like low-molecular-weight heparin to prevent clot propagation and allow the body's fibrinolytic system to stabilize the thrombus. - **Venous Stasis** — The reduction or stoppage of blood flow in the veins, a key factor in thrombus formation that is minimized by leg elevation. ## 같은 주제 문제 - [A postpartum nurse is assessing a client who delivered vaginally 3 days ago and reports le…](https://mymerci.kr/pages/nclex_q.php?qn_id=543177) - [A postpartum client on her third day after vaginal delivery reports sudden onset of sharp …](https://mymerci.kr/pages/nclex_q.php?qn_id=543178) - [A postpartum client on her third day after delivery reports sudden onset of chest pain and…](https://mymerci.kr/pages/nclex_q.php?qn_id=543179) - [A postpartum client diagnosed with deep vein thrombosis (DVT) in the left leg is receiving…](https://mymerci.kr/pages/nclex_q.php?qn_id=543180) - [A postpartum client diagnosed with superficial thrombophlebitis in the left leg is receivi…](https://mymerci.kr/pages/nclex_q.php?qn_id=543181) - [A postpartum client diagnosed with superficial thrombophlebitis in the left leg is being d…](https://mymerci.kr/pages/nclex_q.php?qn_id=543182) --- More free questions: [기출문제](https://mymerci.kr/) _학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._