A nurse is caring for a client who is postoperative following vascular surgery.
Which of the following manifestations should indicate to the nurse that the client has developed a thrombus?

Choice A rationale:

The nurse should not instruct the client to rest with the legs above heart level. While elevating the legs can be helpful for managing symptoms of peripheral artery disease (PAD), it is not a suitable choice for older adults, especially those with heart conditions. It can put additional strain on the heart and may not be appropriate for all clients. Elevation of the legs should be done with caution and under healthcare provider guidance.

Choice B rationale:

The nurse should not advise the client to wear antiembolic stockings during the day. Antiembolic stockings, also known as compression stockings, are primarily used for venous insufficiency and the prevention of deep vein thrombosis (DVT). They may not be effective or necessary for the management of PAD. It's important to tailor the instructions to the specific condition, and in the case of PAD, other strategies may be more appropriate.

Choice C rationale:

The correct answer is choice C. The nurse should instruct the client to adjust the thermostat so that the environment is warm. This is an important recommendation for clients with PAD because keeping the extremities warm can help improve circulation and reduce symptoms. Cold environments can exacerbate the vasoconstriction associated with PAD, leading to more discomfort. Maintaining a warm environment is a simple and effective measure for symptom management.

Choice D rationale:

The nurse should not recommend applying a heating pad on a low setting to help relieve leg pain. While heat can provide temporary relief for muscle pain, it may not be the best option for clients with PAD. Applying heat directly to the affected area can sometimes lead to burns or skin damage, especially in older adults who may have decreased sensation. Heat should be used cautiously, and other methods like keeping the environment warm are preferred.

The correct answer is A. Captopril.

Choice A: Captopril Captopril is an angiotensin-converting enzyme (ACE) inhibitor used to treat conditions like high blood pressure and heart failure. One of the common side effects of ACE inhibitors is a persistent, non-productive cough. This cough occurs due to the accumulation of bradykinin, a potent peptide that can induce coughing.

Choice B: Metoprolol Metoprolol is a beta-blocker used to treat high blood pressure and heart failure. Common side effects include dizziness, slow or irregular heartbeat, and unusual tiredness or weakness. However, it is not typically associated with a non-productive cough.

Choice C: Furosemide Furosemide is a loop diuretic used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder. While it can cause side effects like diarrhea, constipation, and loss of appetite, a non-productive cough is not a typical side effect of Furosemide.

Choice D: Digoxin Digoxin is used to treat heart failure and irregular heartbeat. Common side effects include dizziness, slow or irregular heartbeat, and unusual tiredness or weakness. However, a non-productive cough is not a typical side effect of Digoxin.