A nurse is caring for a client who is postoperative following a total knee replacement. Which of the following actions should the nurse implement to prevent deep vein thrombophlebitis?

Choice A rationale Monitoring the White Blood Cell (WBC) count is primarily a measure for detecting and tracking infection (normal range 4,500–11,000 cells/mm) or inflammatory processes, not a direct preventative action for deep vein thrombophlebitis (DVT). While inflammation can contribute to hypercoagulability, this action doesn't mechanically or chemically prevent venous stasis or hypercoagulability, the Virchow's triad components. Choice B rationale Encouraging increased fluid intake helps to maintain adequate intravascular volume and reduce blood viscosity. Hemoconcentration, resulting from dehydration, increases the concentration of clotting factors and blood cells, making the blood more viscous and sluggish, thus promoting venous stasis and increasing the risk of DVT formation. Choice C rationale Keeping the affected knee flexed can compress the popliteal vein, a major deep vein, especially when maintained for prolonged periods post-operatively. This compression promotes venous stasis distal to the flexion point, which is a critical component of Virchow's triad and significantly increases the risk for deep vein thrombophlebitis development. Choice D rationale Prolonged bed rest, especially beyond 24-48 hours without prophylactic measures, dramatically reduces the activity of the skeletal muscle pump in the lower extremities. This lack of muscle contraction and relaxation greatly impairs venous return to the heart, leading to severe venous stasis and a high risk of deep vein thrombophlebitis.