A nurse is preparing to perform a blood glucose test. After performing hand hygiene and donning gloves, in which order should the nurse perform the following actions to obtain a capillary blood sample? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Choice A Reason:
Checking the client for ecchymosis is appropriate. Thrombocytopenia increases the risk of bleeding and bruising, so monitoring for ecchymosis (bruising) is essential to detect any signs of bleeding. Ecchymosis can occur more easily in individuals with low platelet counts.
Choice B Reason:
Initiating protective isolation for the client is typically unnecessary solely due to thrombocytopenia. Protective isolation is generally for clients with conditions that compromise their immune system or make them more susceptible to infections.
Choice C Reason:
Administering ibuprofen for a mild headache might not be advisable in someone with thrombocytopenia because ibuprofen can affect platelet function and potentially increase the risk of bleeding.
Choice D Reason:
Instructing the client to shave with a disposable razor isn't recommended because using a sharp blade can increase the risk of cuts and bleeding in someone with a low platelet count. Using an electric razor or avoiding shaving might be safer options to prevent injury and bleeding.

Choice A Reason:

Setting the degree of flexion and extension as tolerated by the client is generally appropriate in a CPM device, but this should be done within the prescribed range recommended by the healthcare provider. Simply allowing the client to adjust the degree of flexion and extension without guidance might lead to overextension or inadequate movement, potentially causing discomfort or hindering recovery.

Choice B Reason:

Padding the CPM device with a thick pillow isn't the recommended approach. CPM devices typically come with appropriate padding to ensure comfort and proper positioning. Using a thick pillow might alter the device's mechanics or cause uneven support, affecting the intended movement of the knee.

Choice C Reason:

Placing the client in high-Fowler's position (sitting upright at a 90-degree angle) isn't a standard or necessary position for using a CPM device after a knee arthroplasty. The client can typically use the CPM device while lying in a comfortable and relaxed position, following the healthcare provider's instructions regarding positioning during CPM therapy.

Choice D Reason:

Aligning the client's joints with the joints on the frame is essential for the correct function of the CPM device. This alignment helps in providing the intended range of motion without causing unnecessary stress or strain on the knee joint.