An appropriate nursing intervention when caring for a postpartum mother with thrombophlebitis is:
A. Encourage the mother to ambulate to relieve the pain in the leg.
B. Instruct the mother to apply elastic bondage from the foot going towards the knee to improve venous return flow.
C. Apply warm compress on the affected leg to relieve the pain.
D. Elevate the affected leg and keep the patient on bedrest.
Correct Answer: D. Elevate the affected leg and keep the patient on bed rest.
If the mother already has thrombophlebitis, the nursing intervention is bed rest to prevent the possible dislodging of the thrombus and keeping the affected leg elevated to help reduce the inflammation.
Option A: During pregnancy, an increase in most procoagulant factors and a reduction in fibrinolytic activity occurs. Plasma fibrinogen levels gradually increase after the third month of pregnancy, to double those of the nonpregnant state. In the second half of pregnancy, levels of factors VII, VIII, IX, and X also increase. Decreased fibrinolytic activity is probably related to a decrease in the level of circulating plasminogen activator. In addition, a 68% reduction in protein S levels is measured during pregnancy and in the postpartum period. Protein S levels do not return to the reference range until 12 weeks after delivery. These changes are necessary to prevent hemorrhage during placental separation.
Option B: The routine use of graduated support stockings (class I or II), especially when the patient is confined on an airplane or otherwise, is extremely important.
Option C: A warm water compress is valuable in the treatment of phlebitis, and could decrease the degree of phlebitis both effectively and inexpensively.