A nurse is caring for a client who has a prescription for 81 mg acetylsalicylic acid (Aspirin) daily.
Which of the following actions should the nurse plan to take?

Choice A rationale

While vitamin K, found in green leafy vegetables, is essential for the synthesis of clotting factors (II, VII, IX, X), it is relevant to individuals on warfarin therapy. For general deep vein thrombosis (DVT) prevention, the focus is on promoting venous return and preventing stasis, not dietary modification regarding vitamin K, unless a client is on specific anticoagulants.

Choice B rationale

Massaging lower extremities in a client at risk for DVT is contraindicated because it could theoretically dislodge a pre-existing, non-symptomatic clot. Dislodgement can convert the deep vein thrombus into a pulmonary embolus (PE), a life-threatening complication where the clot travels to the pulmonary vasculature, impeding gas exchange.

Choice C rationale

Sequential compression devices (SCDs) use intermittent, pneumatic pressure to cyclically compress the leg, simulating the action of the skeletal muscle pump. This external compression promotes venous blood flow from the superficial to the deep veins, which effectively reduces venous stasis and the associated risk of thrombus formation, a primary mechanism in DVT pathogenesis.

Choice D rationale

Limiting movement of the lower extremities increases venous stasis, which is a key component of Virchow's triad (venous stasis, endothelial injury, hypercoagulability) and a major risk factor for DVT formation. Promoting activity, such as frequent position changes, ambulation, or ankle pumps, is the core physical intervention for preventing DVT.

Choice A rationale

Hydrochlorothiazide is a thiazide diuretic that works by inhibiting sodium and chloride reabsorption in the distal convoluted tubule. This mechanism causes increased excretion of both water and potassium, making the client susceptible to hypokalemia (serum potassium <3.5 mEq/L), not hyperkalemia, thereby requiring regular electrolyte monitoring.

Choice B rationale

Furosemide is a potent loop diuretic that acts on the ascending limb of the loop of Henle, blocking the reabsorption of sodium, chloride, and potassium. Its high efficacy in causing diuresis leads to significant renal loss of potassium, which places the client at a high risk for developing hypokalemia (serum potassium <3.5 mEq/L), not the elevated levels of hyperkalemia.

Choice C rationale

Mannitol is an osmotic diuretic that acts primarily by increasing the osmotic pressure of the glomerular filtrate, which inhibits the reabsorption of water. It is predominantly used for reducing cerebral edema and intraocular pressure; it does not significantly interfere with the renal tubular handling of potassium, so it poses little risk for hyperkalemia.

Choice D rationale

Spironolactone is a potassium-sparing diuretic that functions as an aldosterone receptor antagonist in the distal nephron. By blocking aldosterone's effects, it promotes sodium and water excretion while retaining potassium, which, especially in clients with impaired kidney function, significantly elevates the risk for life-threatening hyperkalemia (serum potassium >5.0 mEq/L). 80mm.5pt.