A nurse is providing teaching to a client who is postoperative following a mastectomy of the left breast with axillary lymph node dissection. Which of the following exercises should the nurse instruct the client to start on the first postoperative day?

Choice A rationale:

The nurse should not advise the client with multiple sclerosis to schedule all physical activities for the morning hours. While some individuals with multiple sclerosis may experience increased fatigue later in the day, the best approach is to encourage the client to schedule activities at times when they feel the most energetic and to balance physical activity with rest throughout the day.

Choice B rationale:

Monitoring blood pressure is essential while taking fingolimod, a medication used to treat multiple sclerosis, as it can cause a transient decrease in heart rate and blood pressure.

Therefore, the nurse should include this statement in the teaching to ensure the client's safety and early detection of any issues.

Choice C rationale:

This is the correct statement to include in the teaching. Clients with multiple sclerosis should avoid rigorous activities that increase body temperature, as this can worsen their symptoms due to the sensitivity of demyelinated nerves to heat. Activities such as hot baths or engaging in strenuous exercise in hot weather should be avoided.

Choice D rationale:

Corticosteroids are not typically used as a long-term treatment for multiple sclerosis. Instead, they are used for short courses during exacerbations to reduce inflammation and manage acute symptoms. Long-term use of corticosteroids can lead to significant adverse effects, so the nurse should not include this statement in the teaching.

Choice A rationale:
(Potassium level) Lovastatin is a medication used to treat high cholesterol levels. While potassium levels are important to monitor for certain conditions, they are not directly related to the initiation of lovastatin therapy. Therefore, this is not the correct choice for diagnostic testing before starting the medication.
Choice B rationale:
(Hemoglobin level) Hemoglobin levels are important to assess for anemia or other blood disorders. However, they are not specifically required before starting lovastatin therapy. Therefore, this is not the correct choice for diagnostic testing before starting the medication.
Choice C rationale:
(Kidney function tests) While kidney function tests are essential for many medications to ensure proper excretion and avoid toxicity, they are not directly related to the initiation of lovastatin therapy. Therefore, this is not the correct choice for diagnostic testing before starting the medication.
Choice D rationale:
(Liver function tests) Liver function tests are crucial before starting lovastatin therapy. Lovastatin is metabolized in the liver, and it can potentially cause liver damage or abnormalities in liver enzymes. Monitoring liver function helps detect any pre-existing liver conditions and ensures the safe use of the medication. Therefore, this is the correct choice for diagnostic testing before starting the medication.