A nurse is providing education to a client who is scheduled for a left knee arthroplasty. Which of the following statements regarding informed consent indicates client understanding of the teaching?

Choice A reason: Using a donut-shaped cushion is not recommended, as it can increase pressure on surrounding tissues, worsening ischemia in the ischial area. Nonblanchable erythema indicates early pressure injury, requiring pressure relief and skin protection. This intervention risks further tissue damage, making it inappropriate for managing the client’s condition.
Choice B reason: Repositioning every 15 minutes while sitting is excessive and impractical, potentially causing discomfort or skin shear. For paraplegic clients, repositioning every 1-2 hours while sitting, combined with pressure-relieving cushions, prevents progression of nonblanchable erythema. This frequency is not evidence-based for pressure injury prevention, making it incorrect.
Choice C reason: Applying moisture-barrier cream protects the skin from breakdown in the presence of nonblanchable erythema, an early stage of pressure injury. For paraplegic clients, who are at high risk due to immobility, this intervention reduces moisture-related damage and supports skin integrity, aligning with evidence-based pressure injury prevention strategies.
Choice D reason: Repositioning every 3 hours in bed is insufficient for a paraplegic client with nonblanchable erythema, as guidelines recommend every 2 hours to relieve pressure. Prolonged pressure risks advancing tissue damage, especially in high-risk areas like the ischium. This intervention is inadequate for preventing pressure injury progression.

Choice A reason: Advancing the walker and taking a step towards it is the correct technique, ensuring stability by moving the walker first, then stepping. This maintains balance and prevents falls, aligning with safe walker use protocols, so no intervention is needed for this action.
Choice B reason: Taking multiple steps while holding the walker compromises stability, as the walker must be repositioned after each step to ensure support. This increases fall risk, requiring the charge nurse to intervene to correct the technique and ensure the client’s safety during ambulation.
Choice C reason: Grasping the walker by the hand grips on the upper bars is correct, as it provides optimal control and balance. This standard technique supports safe mobility, and no intervention is required, as it adheres to proper walker use guidelines.
Choice D reason: Lifting the walker as it is moved forward is acceptable for lightweight or rolling walkers, depending on the client’s strength and model. While sliding is preferred for standard walkers, lifting is not inherently unsafe, so intervention is unnecessary unless improper execution is observed.