A nurse is providing teaching to a client who has a prescription for oxygen administration at home. Which of the following statements should the nurse include in the teaching?

Rationale:

A. Banana slices: Soft, manageable, and cut into small pieces, banana slices are safe for a toddler to pick up and self-feed. They promote fine motor skill development and independence while minimizing the risk of choking.

B. Popcorn: Popcorn is a choking hazard for toddlers because it is small, hard, and easily inhaled. It is unsafe for children under 4 years and should be avoided when promoting independent eating.

C. Grapes: Whole grapes are also a significant choking risk. If given, they must be cut into small, manageable pieces, so serving them whole does not support safe independent eating.

D. Hot dog: Whole hot dogs are cylindrical and firm, posing a high choking risk for toddlers. Even when sliced lengthwise or chopped, supervision is required, and they are less suitable for promoting safe self-feeding compared to soft fruits like banana slices.

Rationale for correct choices

• heparin 30 units/kg IV bolus once: The diagnostic ultrasound confirms a thrombus in the right leg, indicating acute DVT. Anticoagulation with heparin is the first-line intervention to prevent clot extension and pulmonary embolism. The lab values (normal platelets, normal INR) show no contraindication to starting anticoagulation.

• acetaminophen 650 mg PO every 4 hr PRN: Acetaminophen is appropriate for managing the client’s pain (rated 6/10) without increasing bleeding risk. NSAIDs such as ibuprofen are avoided in DVT because they can impair platelet function and increase bleeding risk once anticoagulation is initiated.

Rationale for incorrect choices

• initiating fluid restriction: Fluid restriction is typically used in conditions like heart failure or hyponatremia, not DVT. Adequate hydration is beneficial in DVT because it helps maintain blood viscosity and supports circulation without affecting clot stability.

• maintaining the extremity below the level of the heart: Lowering the extremity increases venous pressure and can worsen swelling. For DVT, the extremity is usually elevated to promote venous return and reduce edema, so this option does not align with recommended care.

• administering cold packs to the extremity: Cold therapy can cause vasoconstriction and slow venous blood flow, which may worsen thrombosis. Warm compresses improve circulation but are used cautiously and only with provider guidance.