A nurse is preparing a presentation at a senior center about age-related musculoskeletal changes. Which of the following changes should the nurse plan to include?

Choice A reason: Generalized Urticaria

Generalized urticaria, or widespread hives, is a common sign of an allergic transfusion reaction. This reaction occurs when the recipient’s immune system reacts to proteins in the donor blood. Symptoms can range from mild, such as itching and hives, to severe, including anaphylaxis. Immediate intervention typically involves stopping the transfusion and administering antihistamines.

Choice B reason: Distended Jugular Veins

Distended jugular veins are not indicative of an allergic transfusion reaction. This finding is more commonly associated with conditions such as congestive heart failure or fluid overload. In the context of a blood transfusion, it could suggest circulatory overload rather than an allergic reaction.

Choice C reason: Blood Pressure 184/92 mm Hg

An elevated blood pressure reading, such as 184/92 mm Hg, is not specific to an allergic transfusion reaction. While blood pressure changes can occur during a transfusion, they are not a hallmark of an allergic response. This finding could be related to other factors, such as anxiety or pre-existing hypertension.

Choice D reason: Bilateral Flank Pain

Bilateral flank pain is not a typical symptom of an allergic transfusion reaction. This symptom is more commonly associated with hemolytic transfusion reactions, where the recipient’s immune system attacks the donor red blood cells, leading to hemolysis and subsequent kidney pain.

Choice A reason: Wrap the stump with an elastic bandage in a figure-eight configuration

Wrapping the stump with an elastic bandage in a figure-eight configuration is a standard practice in postoperative care for below-the-knee amputations. This method helps to shape and shrink the residual limb, preparing it for a prosthesis fitting. The figure-eight wrap provides even compression, which helps to reduce swelling and promote proper healing. It also helps to prevent the formation of edema and ensures that the residual limb maintains a conical shape, which is ideal for fitting a prosthetic socket.

Choice B reason: Remove the elastic bandage and re-wrap the stump once per day

While it is important to regularly check and adjust the bandage, removing and re-wrapping the stump only once per day may not be sufficient. The bandage should be checked more frequently to ensure it remains properly positioned and provides consistent compression. In some cases, it may need to be adjusted multiple times a day to maintain the desired level of compression and to prevent any issues such as slippage or uneven pressure.

Choice C reason: Perform passive range of motion exercises once daily

Performing passive range of motion exercises is beneficial for maintaining joint flexibility and preventing contractures. However, these exercises should be performed more frequently than once daily, especially in the early postoperative period. Regular exercises help to maintain muscle strength, improve circulation, and promote overall mobility. The frequency and type of exercises should be tailored to the individual needs of the client and guided by a physical therapist.

Choice D reason: Secure the elastic bandage to the lowest joint

Securing the elastic bandage to the lowest joint is not recommended. The bandage should be wrapped in a way that provides even compression without restricting movement or circulation. The figure-eight configuration is preferred because it allows for better control of the compression and helps to shape the residual limb effectively. Securing the bandage to a joint can lead to discomfort and may impede proper blood flow.