A nurse is admitting a client who is to undergo paracentesis for removal of ascitic fluid. Which of the following actions should the nurse take?

• Deep vein syndrome: This is not a recognized condition. The intended term may have been deep vein thrombosis (DVT), which is a valid orthopedic complication, but the clinical findings in this scenario point more urgently toward compartment syndrome and infection.
• Osteomyelitis: The client has an open fracture with drainage from the splint, a significantly elevated WBC count (28,000/mm³), and a high fever (38.9°C / 102°F). These findings suggest the development of a bone infection (osteomyelitis), especially in the context of recent surgery and internal fixation.
• Fat embolism syndrome: While fat embolism is a risk with long bone fractures, this client is not displaying key hallmark signs such as respiratory distress, petechiae, or altered mental status. The findings are more consistent with infection and circulatory compromise.
• Compartment syndrome: The client has classic signs including cool foot, numbness, inability to move toes, absent pulses, delayed capillary refill, and increased pain. These are hallmark signs of neurovascular compromise from compartment syndrome, a surgical emergency.

A. Wear clothing with zippers instead of buttons. This may be helpful for caregivers or for promoting independence in dressing, but it does not directly enhance safety in the home for a client with Alzheimer’s disease.
B. Place locks at the tops of exterior doors. Clients with Alzheimer’s are at risk for wandering, especially in later stages. Placing locks at the tops of doors helps prevent elopement while still allowing caregivers to control access, thus enhancing home safety.
C. Replace the carpet with hardwood floors. Carpets can actually provide more traction and cushioning than hardwood, which may be slippery and increase the risk of falls. Removing carpet is not necessary and could reduce safety.
D. Encourage physical activity prior to bedtime. Physical activity is beneficial but should be scheduled earlier in the day, as exercise close to bedtime may increase stimulation and interfere with sleep, which is already often disrupted in Alzheimer’s clients.