A nurse is preparing to apply a thigh-length sequential compression device for a client who is postoperative. Which of the following actions should the nurse take?

Wrap the sleeve loosely around the client's lower leg

Measure the circumference of the client's upper leg.

Turn on the mechanical unit prior to applying the sleeve

Position the client prone to apply the device.

Answer and Explanation

The Correct Answer is B

A. Wrap the sleeve loosely around the client's lower leg: The sleeve should fit snugly but comfortably to ensure effective compression. Wrapping it too loosely reduces efficacy in promoting venous return and preventing deep vein thrombosis. Proper fit is essential for device function and patient safety.

B. Measure the circumference of the client's upper leg: Measuring the thigh circumference ensures the correct sleeve size is selected, which is crucial for effective compression and prevention of pressure injury. Accurate sizing allows the device to deliver appropriate pressure without causing discomfort or circulatory compromise.

C. Turn on the mechanical unit prior to applying the sleeve: The device should remain off until the sleeve is properly positioned on the client. Activating it beforehand may result in improper inflation, skin injury, or ineffective compression. Turning it on too early can also startle the client and reduce comfort.

D. Position the client prone to apply the device: The client should be supine or with legs slightly elevated when applying a thigh-length sequential compression device. Prone positioning is unnecessary, uncomfortable, and can complicate proper sleeve placement. Supine positioning facilitates correct alignment and device effectiveness.

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Correct Answer is B

Explanation

A. Coffee: Coffee is a stimulant and can increase gastrointestinal motility, which may worsen diarrhea. It does not help restore the balance of gut flora disrupted by antibiotics and is not recommended.

B. Yogurt: Yogurt contains probiotics, which help replenish healthy intestinal bacteria that can be reduced during antibiotic therapy. Consuming yogurt can help restore gut flora balance and reduce the likelihood or severity of antibiotic-associated diarrhea.

C. Apple juice: Apple juice is high in sugar and can have an osmotic effect in the intestines, potentially worsening diarrhea. It does not contribute to restoring normal gut flora and is not recommended to prevent antibiotic-related diarrhea.

D. Ice cream: Ice cream contains lactose, which can be difficult for some clients to digest, especially when gut flora is disrupted by antibiotics. This may exacerbate diarrhea rather than reduce it, making it inappropriate.

A. Monitor urine for protein. B. Obtain a nasopharyngeal swab C. Request an x-ray of the neck. D. Administer fluconazole

Correct Answer is C

Explanation

A. Monitor urine for protein: Proteinuria is unrelated to epiglottitis and does not provide useful information for assessing airway compromise. This intervention is not indicated for this condition.

B. Obtain a nasopharyngeal swab: Swabbing the throat can trigger gagging or laryngospasm, which may cause complete airway obstruction in a child with epiglottitis. Invasive procedures should be avoided until the airway is secured.

C. Request an x-ray of the neck: A lateral neck x-ray can help confirm the diagnosis of epiglottitis by showing a swollen epiglottis ("thumb sign"). Imaging is useful when performed carefully in a controlled environment.

D. Administer fluconazole: Fluconazole is an antifungal medication and is not indicated for bacterial epiglottitis, which is typically caused by Haemophilus influenzae type b or other bacteria.

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A nurse is preparing to apply a thigh-length sequential compression device for a client who is postoperative. Which of the following actions should the nurse take?

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