A nurse is performing a home safety assessment on a client who has a hip fracture. Which of the following observations should the nurse identify as a safety hazard?

Rationale:

A. Encourage the client to elevate their legs while in bed: Elevating the affected leg helps reduce venous pressure, decreasing edema and discomfort associated with DVT. Elevation also promotes venous return, which can limit further clot propagation. This intervention provides symptom relief without increasing the risk of embolization.

B. Place an immobilizer on the affected leg: Immobilizers restrict movement and are used for musculoskeletal injuries, not for DVT management. Immobilization can worsen venous stasis by reducing circulation in the lower extremity. Instead, clients with DVT benefit from gentle mobility once anticoagulation is initiated, unless contraindicated, to prevent worsening clot burden.

C. Implement bleeding precautions: The client has diagnostic confirmation of DVT and will require anticoagulation, which increases bleeding risk. Bleeding precautions help prevent complications such as hematuria, bruising, or gastrointestinal bleeding. Monitoring for signs of bleeding and avoiding trauma are essential once therapy begins.

D. Apply intermittent pneumatic compression devices to the unaffected leg: IPC devices should not be applied to the affected limb due to the risk of dislodging the thrombus. However, using them on the unaffected leg promotes venous return and helps prevent additional clot formation.

E. Instruct the client to expect dark stools: Dark stools can indicate gastrointestinal bleeding, which is not an expected effect of DVT treatment. While anticoagulants can increase bleeding risk, the nurse should teach the client to report black or tarry stools immediately.

Rationale:

A. "What questions do you have about reading food labels?": This question assesses nutrition literacy rather than dietary acculturation. It focuses on understanding nutritional information, not cultural food practices or adaptations.

B. "Do you have special customs that you follow for meals?": This question directly addresses dietary acculturation by exploring cultural or traditional food practices and meal patterns. It helps the nurse understand how the client’s cultural background influences their diet and eating behaviors.

C. "Are there any foods that you are allergic to?": This question assesses food safety and potential allergens, not cultural or acculturation aspects of the diet.

D. "How do you feel about your current body weight?": This question addresses body image and personal perception, which may influence dietary choices but does not provide information about cultural or acculturation influences on diet.