An 83-year-old patient who had a surgical repair of a hip fracture two days ago now has ambulation restrictions. Based on this information, which potential complication is the priority collaborative problem?

• A. Hypovolemic shock
• B. Venous thromboembolism
• C. Fluid and electrolyte imbalance
• D. Impaired surgical wound healing

Answer: (B)

Immobilization after a hip surgery creates venous stasis in the legs, which, together with recent surgical trauma, markedly increases the risk of developing a blood clot. In an older patient, this risk is even higher because age and comorbidities often weaken the body's ability to prevent clot formation. A DVT can remain silent but has the potential to travel to the lungs and cause a life-threatening pulmonary embolism, making prevention and early detection the top priority for the care team.

So the focus is on preventing venous thromboembolism: using pharmacologic prophylaxis as ordered (such as anticoagulants appropriate for the patient), applying mechanical methods to promote venous return (like sequential compression devices or compression stockings), and encouraging safe movement as soon as allowed. Monitoring for signs of a developing clot—leg swelling, redness, warmth, calf tenderness, or new chest symptoms like pain and shortness of breath—is essential to intervene promptly.

While other issues like fluid balance or wound healing are important, they do not pose the immediate, life-threatening risk that a postoperative VTE does in this scenario.