A nurse is reinforcing discharge teaching with a client who has undergone a vein stripping of the right leg. Which of the following instructions should the nurse include in the teaching?
Maintain bed rest for 48 hr.
Keep legs in a dependent position.
Wrap the leg with an elastic bandage.
Implement a sodium-restricted diet.
The Correct Answer is C
The client should wrap the leg with an elastic bandage to reduce swelling and promote healing.
The client should not maintain bed rest, as this can increase the risk of thrombosis and infection.
The client should elevate the leg above the heart level, not keep it in a dependent position, as this can reduce venous pressure and edema.
The client does not need to implement a sodium-restricted diet, as this is not related to vein stripping.
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Related Questions
Correct Answer is C
Explanation
The correct answer is C. Place a pillow under the child's head.
Rationale: The nurse should protect the child from injury by helping them to the floor and clearing away furniture or other items. The nurse should also place a pillow under the child's head to prevent head trauma and turn them onto their side to prevent aspiration of saliva or vomit. The nurse should not put anything in the child's mouth, as this could cause choking or damage to the teeth or tongue. The nurse should also not turn the child onto their back, as this could compromise their airway. The nurse should not restrain the child's upper extremities, as this could increase muscle spasms and cause injury.
Correct Answer is C
Explanation
Choice A reason
Increased food intake does not show medication is effective: Increased food intake is not a specific indication of donepezil's effectiveness. While some clients with dementia may have improved appetite due to reduced agitation or confusion, it is not directly related to the medication's therapeutic effect.
Choice B reason:
Can perform ADLs independently is inappropriate: The ability to perform activities of daily living (ADLs) independently can be a positive outcome in clients with dementia. However, it may not be solely attributed to donepezil, as ADLs can be influenced by various factors, including the client's overall condition and support received.
Choice C reason:
Improved short-term memory is correct. One of the primary goals of using donepezil is to improve memory and slow the decline in cognitive abilities associated with dementia. Therefore, if a client shows improvement in short-term memory, it suggests that the medication is having a positive effect in preserving cognitive function.
Choice D reason
Enhanced mood does not show the medicine is effective: Donepezil is primarily aimed at improving cognitive function and memory, and its effects on mood may be limited. While some clients may experience mood improvements due to reduced frustration or confusion from memory loss, it is not the primary indicator of the medication's effectiveness
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