The nurse is planning care for a client with deep venous thrombosis (DVT).Which nursing diagnosis would be a priority for this client?
A) Risk for Infection related to obstructed venous return
B) Excess Fluid Volume related to tissue edema
C) Ineffective Tissue Perfusion related to obstructed venous return
D) Disturbed Sleep Pattern related to tissue hypoxia

Question

Quizplus · Accepted Answer

A) Ineffective Tissue Perfusion related to obstructed venous return is the correct diagnosis because it identifies the underlying cause. Excess Fluid Volume related to tissue edema and Disturbed Sleep Pattern related to tissue hypoxia are incorrect because they do not identify the underlying cause. Risk for Infection related to obstructed venous return would be a priority if complications of infection were present, however this is not the case.
B) Ineffective Tissue Perfusion related to obstructed venous return is the correct diagnosis because it identifies the underlying cause. Excess Fluid Volume related to tissue edema and Disturbed Sleep Pattern related to tissue hypoxia are incorrect because they do not identify the underlying cause. Risk for Infection related to obstructed venous return would be a priority if complications of infection were present, however this is not the case.
C) Ineffective Tissue Perfusion related to obstructed venous return is the correct diagnosis because it identifies the underlying cause. Excess Fluid Volume related to tissue edema and Disturbed Sleep Pattern related to tissue hypoxia are incorrect because they do not identify the underlying cause. Risk for Infection related to obstructed venous return would be a priority if complications of infection were present, however this is not the case.
D) Ineffective Tissue Perfusion related to obstructed venous return is the correct diagnosis because it identifies the underlying cause. Excess Fluid Volume related to tissue edema and Disturbed Sleep Pattern related to tissue hypoxia are incorrect because they do not identify the underlying cause. Risk for Infection related to obstructed venous return would be a priority if complications of infection were present, however this is not the case.

The Nurse Is Planning Care for a Client with Deep